Shane Park, CRNA
NPI 1629520127 · Certified Registered Nurse Anesthetist · Oro Valley, AZ
Enrolled with Medicare as Practitioner - Certified Registered Nurse Anesthetist (crna) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shane Park, CRNA is a Certified Registered Nurse Anesthetist provider in Oro Valley, AZ (NPI 1629520127).
Provider details
- NPI number
- 1629520127
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 95000619 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 11234 Anderson StreetLoma Linda, CA 92354Phone: (213) 700-0178
Registry dates
- Enumerated
- 2016-10-31
- Last updated
- 2025-04-28
- Certified
- 2025-04-28
Frequently asked questions
- What is Shane Park's NPI number?
- Shane Park's National Provider Identifier (NPI) is 1629520127, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shane Park's specialty?
- Shane Park is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shane Park located?
- Shane Park's practice location on file with NPPES is 1551 E Tangerine Rd, Oro Valley, AZ 85755-6213.
- What is Shane Park's phone number?
- The practice phone number listed in the NPPES registry for Shane Park is (520) 901-3500.
- Does Shane Park accept Medicare?
- Shane Park is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shane Park's NPI active?
- Yes — Shane Park's NPI (1629520127) is active in the NPPES registry as of the last update on 2025-04-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.