Individual provider Active NPI

Allen Mesick, CRNA

  • Certified Registered Nurse Anesthetist
  • Norfolk, VA
National Provider Identifier
1093723801
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
24166464 Issued in VA
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 668-3871
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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 24166464 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0055

Other identifiers 1

IdentifierTypeStateIssuer
010155339MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150306001466 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032151253 Reassigns benefits to 2 organizations
I20160420002082 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032151253 Reassigns benefits to 2 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
Berkshire Medical Center IncGroup PAC ID 1355232711, 195 clinicians

Practice addresses (Care Compare)

725 N St
Pittsfield, MA 01201-4109
Phone (413) 447-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24166464VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Medical Center Inc. CurrentSince Feb 2, 2016 Accepting new patients
Berkshire Medical Center, Inc CurrentSince Feb 2, 2016 Accepting new patients
Cobble Hill Anesthesia PLLC CurrentSince May 16, 2023 Accepting new patients
JJM Medical Services, PC CurrentSince Jul 1, 2016 Accepting new patients
Cataract & Laser Center West, LLC Past Accepting new patients

Locations

321 Billerica Rd
Chelmsford, MA 01824
Phone (978) 256-3219

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

90 New State Hwy
Raynham, MA 02767
Phone (508) 823-7473

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

171 Interstate Dr
Ste 1
West Springfield, MA 01089
Phone (413) 737-5500

300 Grove St
Worcester, MA 01605
Phone (508) 754-0700

5 Johnson Rd
Latham, NY 12110
Phone (518) 767-0869

1182 Troy Schenectady Rd
Ste 201
Latham, NY 12110
Phone (518) 649-8082

207 Troy Schenectady Rd
Latham, NY 12110
Phone (518) 389-2869

450 Margaret St
Plattsburgh, NY 12901
Phone (518) 561-5180

135 North Rd
#2
Wilton, NY 12831
Phone (518) 450-1304

Organizations & group practices 5

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1093723801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BUSINESS PARK DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626523",
            "telephone_number": "757-473-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-668-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESICK",
        "first_name": "ALLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "24166464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010155339",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.