Individual provider Active NPI

Melissa Dibben, CRNA

  • Certified Registered Nurse Anesthetist
  • Falls Church, VA
National Provider Identifier
1083251623
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024183476 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-4001
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN714295 PA
Certified Registered Nurse Anesthetist 367500000X 0024183476 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

550 Morse St NE Apt 331
Washington, DC 20002-7193
Phone (678) 936-0382

Other practice location 1

1020 Progress St Apt M712
Pittsburgh, PA 15212-5963
Phone (678) 936-0382

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220601001924 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800274986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Virginia, LLCGroup PAC ID 6608268826, 407 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN714295PAMDCritical Care Medicine Registered Nurse
0024183476VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jun 12, 2023 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Feb 23, 2022 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Feb 23, 2022 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1083251623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MORSE ST NE APT 331",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200027193",
            "telephone_number": "678-936-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Progress St Apt M712",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152125963",
            "country_code": "US",
            "telephone_number": "678-936-0382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIBBEN",
        "first_name": "MELISSA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN714295",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024183476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.