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

Mary Carrillo

Individual provider Registered Nurse · NPI 1356722268

Mary Carrillo is a Certified Registered Nurse Anesthetist (CRNA) in Florham Park, New Jersey. Qualified in 2015, 11 years ago. Practices with Summit Medical Group PA, a 1,205-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
11
Licensed in
NJ
In the registry since
2015
Specialties on file
2

Practice location Address checks out

140 Park Ave
Florham Park, NJ 07932-1049
Phone: (973) 404-9700
Fax: (973) 377-4709
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 26NJ00602400 (NJ)
Registered Nurse Taxonomy 163W00000X · Licence 26NR12741800 (NJ)

Record details

NPI number1356722268
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 16, 2015
Last updated in NPPESJanuary 11, 2018
Mailing address100 Route 59, Suite 105, Suffern, NY 10901-4927

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Summit Medical Group Pa — 1205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Florham Park