Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARK R. DVORAK CRNA
NPI 1699750661
Nurse Anesthetist, Certified Registered in Lake Geneva, WI

Q: What is Mark Dvorak's NPI number?

The NPI number for Mark Dvorak is 1699750661. It was assigned to this individual provider in the NPPES registry on December 13, 2005.

Q: What is Mark Dvorak's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mark Dvorak was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days 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.

Active since December 13, 2005PECOS EnrolledAccepts Medicare Assignment

N2950 STATE ROAD 67, LAKE GENEVA, WI 53147(262) 245-4990(262) 245-2248 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 29, 2026, Jun 13, 2016 (2 updates tracked since 2016).

On this page

About Mark R. Dvorak Crna NPPES

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

MARK R. DVORAK CRNA (NPI 1699750661) is an individual nurse anesthetist, certified registered in Lake Geneva, Wisconsin, licensed in Wisconsin (104604-030) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Mercy Walworth Hospital & Medical Center, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1699750661

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameMARK R. DVORAKCredential: CRNA

Location AddressN2950 STATE ROAD 67Lake Geneva, WI 53147-2655

Mailing AddressN2950 State Road 67Lake Geneva, WI 53147-2655 · (262) 245-4990 · Fax (262) 245-2248

Phone(262) 245-4990

Fax(262) 245-2248

Sole ProprietorNo

Medical School CMSOtherGraduated 1986

Enumeration DateDecember 13, 2005

Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration

✔ NPI 1699750661 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 WI · 104604-030

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 ListedNurse PractitionerTaxonomy 363L00000X · License 1149-33 (WI)

N2950 STATE ROAD 67, Lake Geneva, WI 53147

Open in Google Maps ↗

Other Identifiers 4

OtherDVORAMARWI · Mercycare Insurance

Other430067408Rail Road Medicare

Medicaid1699750661WI

Medicaid43372600WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark R. Dvorak Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800924085

PECOS Enrollment IDI20100507000807

Eligible to Order & Refer✔ Part B Labs & Imaging– Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mark Dvorak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mercy Health System Corporation

Same address

Critical Access

N2950 STATE ROAD 67
Lake Geneva, WI 53147

Reassigned Medicare billing, Wisconsin enrollment
Also billed through NPI 1598718603 (Wisconsin)
271 clinicians in this Medicare group

NPI 1699728550 (262) 245-0535

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Walworth Hospital & Medical Center

Critical Access Hospitals · Lake Geneva, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number521357

LocationN2950 State Road 67Lake Geneva, WI 53147 · Walworth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53147 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE A RICE LPC

Counselor (Professional)