Individual provider Active NPI

Maritza Gallegos-Mahmood, CRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1124359385
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
084214 Issued in VA
Practice address
1602 Skipwith Rd
Richmond, VA 23229-5205
Phone
(804) 289-4937
NPI assigned
Jan 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001208734 VA
Certified Registered Nurse Anesthetist 367500000X 084214 VA Primary

Addresses

Primary practice location

1602 Skipwith Rd
Richmond, VA 23229-5205

Mailing address

9720 Pemberton Crossing Dr
Richmond, VA 23294-5345
Phone (804) 447-4816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000624 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456488063 Reassigns benefits to 2 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
Dogwood Anesthesia Providers LLCGroup PAC ID 2769853084, 141 clinicians

Practice addresses (Care Compare)

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (804) 520-8272

Hospital & facility affiliations

  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001208734VAMDRegistered Nurse
084214VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dogwood Anesthesia Providers, LLC CurrentSince Dec 30, 2022 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince May 1, 2021 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince May 1, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

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 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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1124359385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 PEMBERTON CROSSING DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232945345",
            "telephone_number": "804-447-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295205",
            "telephone_number": "804-289-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS-MAHMOOD",
        "first_name": "MARITZA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001208734",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "084214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.