Colleen T Masternick, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN-165483 Issued in OH

Practice address

8135 Market St
Youngstown, OH 44512-6244

Phone

(330) 758-0900

Fax

(330) 758-2790

NPI assigned

Mar 1, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bel-Park Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Youngstown, OH
  • NPI 1508813528

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1013984749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126244",
            "telephone_number": "330-758-0900",
            "fax_number": "330-758-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4147 Westford Dr",
            "address_purpose": "LOCATION",
            "city": "Canfield",
            "state": "OH",
            "postal_code": "444068086",
            "country_code": "US",
            "telephone_number": "330-702-1489",
            "fax_number": "330-702-1545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERNICK",
        "first_name": "COLLEEN",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN-165483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000644312",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0770205",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8246361",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11932484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliana Merle Massarelli, MS
• Cheyenne W Massey, CDCA
• Dianna Massian
• Ana Massiello, AUD
• McKenzie Rae Massucci
• Gina Marie Matash, CNP
• Margaret A Matasic
• Gilda Isabel Mateo, MD
• Shyla Rachel Mathai, M.D.
• Ana Maria Matias

• Certified Registered Nurse Anesthetist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.