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

Mark Sistoso

Individual provider Certified Registered Nurse Anesthetist · NPI 1720407752

Mark Sistoso is a Certified Registered Nurse Anesthetist (CRNA) in Fort Sill, Oklahoma. Qualified in 2013, 13 years ago. Practices with Renew Medical Group of Arkansas Ltd, a 127-clinician group and accepts Medicare assignment. Licensed in Arkansas and Washington.

Years since qualifying
13
Licensed in
AR, WA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

4301 Wilson St
Fort Sill, OK 73503-4472
Phone: (719) 205-0017
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence AP60451158 (WA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence C003258 (AR)

Record details

NPI number1720407752
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 7, 2014
Last updated in NPPESSeptember 19, 2018
Mailing address4 Nw Stonebrook Dr, Lawton, OK 73505-9599

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Renew Medical Group Of Arkansas Ltd — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fort Sill