Individual provider Active NPI

Susan F Dimassa, CRNA

  • Certified Registered Nurse Anesthetist
  • Elyria, OH
National Provider Identifier
1144389222
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.03829-NA Issued in OH
Practice address
5319 Hoag Drive
Elyria, OH 44035-1494
Phone
(440) 930-6050
Fax
(440) 934-8882
NPI assigned
Dec 6, 2006
Last updated
Feb 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 42507 OH
Certified Registered Nurse Anesthetist 367500000X COA.03829-NA OH Primary

Addresses

Primary practice location

5319 Hoag Drive
Elyria, OH 44035-1494

Mailing address

13523 Barrett Parkway Drive
Suite 104
Ballwin, MO 63021-2802
Phone (636) 549-2380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42507OHMDCertified Registered Nurse Anesthetist
COA.03829-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Crna of Blanchard Valley LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Licking Memorial Professional Corporation Past Accepting new patients
Ohio Surgical Anesthesia LLC Past Accepting new patients
Associated Anesthesiologists of Toledo, Inc Past Accepting new patients
Northcoast Anesthesia Providers Past Accepting new patients

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1144389222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13523 BARRETT PARKWAY DRIVE",
            "address_2": "SUITE 104",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630212802",
            "telephone_number": "636-549-2380",
            "fax_number": "314-569-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 HOAG DRIVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351494",
            "telephone_number": "440-930-6050",
            "fax_number": "440-934-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMASSA",
        "first_name": "SUSAN",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "42507",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.03829-NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.