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

Individual provider Certified Registered Nurse Anesthetist · NPI 1962499293

Mr. Mark Sean Mattingly, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Philadelphia, Pennsylvania. Qualified in 2002, 24 years ago. Practices with Jefferson University Physicians, a 1,554-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
24
Licensed in
PA
In the registry since
2005
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

230 N Broad St
Philadelphia, PA 19102-1121
Phone: (215) 762-7922
Fax: (215) 762-8656
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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 RN560464 (PA)

Record details

NPI number1962499293
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedOctober 3, 2005
Last updated in NPPESMay 16, 2014

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Jefferson University Physicians — 1554 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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