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

Marshall Barr Bergen, CRNA

Individual provider Registered Nurse · NPI 1003578568

Marshall Barr Bergen, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Phoenix, Arizona. Qualified in 2016, 10 years ago. Practices with Copper Star Anesthesia LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2021
Specialties on file
2
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

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone: (480) 256-1518
Fax: (480) 304-3446
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 269219 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence RN192249 (AZ)

Record details

NPI number1003578568
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedOctober 12, 2021
Last updated in NPPESFebruary 17, 2022
Certification dateFebruary 17, 2022

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Copper Star Anesthesia Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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