Individual provider Active NPI

Mason Salyers

  • Certified Registered Nurse Anesthetist
  • Bridgeport, WV
National Provider Identifier
1104645696
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
119175 Issued in WV
Practice address
327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone
(681) 342-1000
NPI assigned
Oct 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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 119175 WV
Certified Registered Nurse Anesthetist 367500000X 119175 WV Primary

Addresses

Primary practice location

327 Medical Park Dr
Bridgeport, WV 26330-9006

Mailing address

3936 Cloverlea St
Pittsburgh, PA 15227-3404
Phone (606) 634-6636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321001578 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628590338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1842

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119175WVMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2025 Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

Organizations & group practices 1

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 1

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1104645696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3936 CLOVERLEA ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152273404",
            "telephone_number": "606-634-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MEDICAL PARK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309006",
            "telephone_number": "681-342-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALYERS",
        "first_name": "MASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WV",
            "license": "119175",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "119175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.