Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark D. Banderman, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1558577189

Mark D. Banderman, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Kansas City, Missouri. Qualified in 2007, 19 years ago. Practices with Prodigy Office Anesthesia, LLC, an 8-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
19
Licensed in
MO
In the registry since
2007
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

2301 Holmes St
Kansas City, MO 64108-2640
Phone: (816) 404-1127
Fax: (816) 404-1103
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12300 Metcalf Ave, Overland Park, KS 66213-1324 — (816) 389-6030

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 134568 (MO)

Record details

NPI number1558577189
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMay 14, 2007
Last updated in NPPESNovember 23, 2020
Certification dateNovember 23, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Prodigy Office Anesthesia, Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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