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

Shane Park, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1629520127

Shane Park, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Oro Valley, Arizona. Qualified in 2016, 10 years ago. Practices with Ias Arizona PLLC, a 127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and California.

Years since qualifying
10
Licensed in
AZ, CA
In the registry since
2016
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

1551 E Tangerine Rd
Oro Valley, AZ 85755-6213
Phone: (520) 901-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11234 Anderson Street, Loma Linda, CA 92354 — (213) 700-0178

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 233774 (AZ)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 95000619 (CA)

Record details

NPI number1629520127
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedOctober 31, 2016
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025
Mailing address11234 Anderson St, Loma Linda, CA 92354-2804

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 Ias Arizona Pllc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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