Individual provider Active NPI

Melissa C Hicks, CRNA

  • Certified Registered Nurse Anesthetist
  • Oceanside, CA
National Provider Identifier
1053643387
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA3889 Issued in CA
Practice address
200 Mercy Circle
Oceanside, CA 92055
Phone
(760) 685-1296
NPI assigned
Feb 11, 2010
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA3889 CA Primary

Addresses

Primary practice location

200 Mercy Circle
Oceanside, CA 92055

Mailing address

PO Box 555191
Camp Pendleton, CA 92055-5191

Other practice location 1

207 W Legion Rd
Brawley, CA 92227-7780
Phone (760) 351-3333

Other practice location 2

2615 Chester Ave
Bakersfield, CA 93301-2014
Phone (661) 395-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000242 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800921974 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

400 Newport Ctr Dr
Suite 609
Newport Beach, CA 92660-7695
Phone (949) 760-0398

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3889CAMDSpeech-Language Assistant
NA3889CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Temecula Ca United Surgery Center LP CurrentSince Dec 23, 2015 Accepting new patients
United Medical Doctors CurrentSince Jan 1, 2016 Accepting new patients
Temecula Ca United Surgery Center, LP Current Accepting new patients
Temecula Ca Endoscopy ASC LP CurrentSince Dec 23, 2015 Accepting new patients
Temecula Ca Endoscopy ASC LP Current Accepting new patients
United Medical Doctors Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
Pioneers Memorial Healthcare District Past Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

25150 Hancock Ave
Ste 208
Murrieta, CA 92562
Phone (951) 698-8805

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

31469 Rancho Pueblo Rd
Ste 100
Temecula, CA 92592
Phone (951) 249-5540

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1053643387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-685-1296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 W Legion Rd",
            "address_purpose": "LOCATION",
            "city": "Brawley",
            "state": "CA",
            "postal_code": "922277780",
            "country_code": "US",
            "telephone_number": "760-351-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2615 Chester Ave",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933012014",
            "country_code": "US",
            "telephone_number": "661-395-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MELISSA",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.