Individual provider Active NPI

Melissa Grcic-Jacobelli, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, MO
National Provider Identifier
1023094372
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2017030456 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 882-2568
Fax
(573) 882-2226
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2017030456 MO Primary
Certified Registered Nurse Anesthetist 367500000X ARNP9242991 FL

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 882-3300

Other practice location 1

421 SE Alfred Markham St
Lake City, FL 32025-2204
Phone (386) 697-1364

Other practice location 2

1 Barnes Jewish Hospital Plz Dept Of
Saint Louis, MO 63110-1003
Phone (800) 862-9980

Other identifiers 3

IdentifierTypeStateIssuer
004081725MedicaidCT
G4068OtherFLBCBSFL
307838800MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031000211 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547202053 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington University 2,968 clinicians
The Curators of the University of Missouri 1,108 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
003234CTMDMental Health Counselor

Practice roles (15 of 16)

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2022 Accepting new patients
Washington University CurrentSince Aug 21, 2024 Accepting new patients
Washington University CurrentSince Aug 21, 2024 Accepting new patients
Mid-America Anesthesia Consultants, PC CurrentSince Feb 1, 2024 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
The Curators of the University of Missouri CurrentSince Oct 16, 2017 Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince May 22, 2023 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince May 22, 2023 Accepting new patients
Curators of the University of Missouri CurrentSince Oct 16, 2017 Accepting new patients
Orlando Anesthesia Consultants PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Griffin Anesthesia Associates PC Past Accepting new patients
Milford Anesthesia Associates LLC Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 Accepting new patients
NM Anesthesia Associates, PC Past Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1600 E Broadway
Ste 60
Columbia, MO 65201

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

3520 W Edgewood Dr
Jefferson City, MO 65109
Phone (573) 556-7765

1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

4960 Childrens Pl
Fl 2
Saint Louis, MO 63110
Phone (314) 362-1520

1 Barnes Jewish Hospital Plz
#P
Saint Louis, MO 63110
Phone (618) 474-1074

40 Sunset Ridge Rd
Ste 120
New Paltz, NY 12561

Networks

  • Freedom Health HMO Network

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1023094372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-882-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-2568",
            "fax_number": "573-882-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 SE Alfred Markham St",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320252204",
            "country_code": "US",
            "telephone_number": "386-697-1364",
            "fax_number": "888-370-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Barnes Jewish Hospital Plz Dept Of",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "800-862-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRCIC-JACOBELLI",
        "first_name": "MELISSA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2017030456",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9242991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004081725",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "G4068",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307838800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.