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SHAUN MARDANI CRNA
NPI 1366870008
Nurse Anesthetist, Certified Registered in San Clemente, CA

Active since October 16, 2013
120 CALLE AMISTAD UNIT 3207, SAN CLEMENTE, CA 92673(949) 292-3023 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shaun Mardani Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAUN MARDANI CRNA (NPI 1366870008) is an individual nurse anesthetist, certified registered in San Clemente, California, licensed in California (4443) and active in the NPI registry since October 2013.

NPPES Registry Identity

NPI1366870008
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameSHAUN MARDANICredential: CRNA
Location Address120 CALLE AMISTAD UNIT 3207San Clemente, CA 92673-6923
Mailing Address120 Calle Amistad Unit 3207San Clemente, CA 92673-6923 · (949) 292-3023
Phone(949) 292-3023
Sole ProprietorYes
Enumeration DateOctober 16, 2013
Last NPPES UpdateDecember 27, 2021
NPPES CertifiedDecember 27, 2021
✔ NPI 1366870008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 4443
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License 767550 (CA)
120 CALLE AMISTAD UNIT 3207, San Clemente, CA 92673
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaun Mardani Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Shaun Mardani reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
31 mi
Health Maintenance Organization
441 N LAKEVIEW AVE
Anaheim, CA 92807
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1952333460 (714) 279-4000
Santa Monica Medical Institute Inc
65 mi
Ophthalmology
1908 SANTA MONICA BLVD, 3
Santa Monica, CA 90404
  • Reassigned Medicare billing, California enrollment
  • 12 clinicians in this Medicare group
NPI 1538351283 (310) 829-5475

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shaun Mardani's NPI number?

The NPI number for Shaun Mardani is 1366870008. It was assigned to this individual provider in the NPPES registry on October 16, 2013.

Where is Shaun Mardani located?

Shaun Mardani practices at 120 Calle Amistad Unit 3207, San Clemente, CA 92673. The listed phone number is (949) 292-3023.

What is Shaun Mardani's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Shaun Mardani enrolled in Medicare?

Yes. Shaun Mardani is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shaun Mardani's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaun Mardani reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Anaheim, CA) and Santa Monica Medical Institute Inc (Santa Monica, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shaun Mardani's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shaun Mardani was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.