Mark Mizuba, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0024166707 Issued in VA

Practice address

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Phone

(540) 853-0222

Fax

(540) 981-7855

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Pittsburgh School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carilion Professional Services LLCGroup PAC ID 2163323999, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carilion Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • Roanoke, VA
  • NPI 1184634156
  Medicare reassignment Care Compare group
• Anesthesiology Associates of Radford Inc

  • Anesthesiology Physician
  • Christiansburg, VA
  • NPI 1407878465
  NPD (past)
• Blair County Anesthesia, P.C.

  • Anesthesiology Physician
  • Altoona, PA
  • NPI 1003864612
  NPD (past)
• Lexington Anesthesia Associates, Inc.

  • Certified Registered Nurse Anesthetist
  • Altoona, PA
  • NPI 1932144029

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carilion Franklin Memorial Hospital

  • General Acute Care Hospital
  • Rocky Mount, VA
  • NPI 1710970918
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1164439899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-853-0222",
            "fax_number": "540-981-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 Roanoke Blvd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241536404",
            "country_code": "US",
            "telephone_number": "540-982-2463 x2250",
            "fax_number": "540-983-1090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZUBA",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024166707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010218608",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010218641",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010218632",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010218705",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010218748",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Ann Mitchell, PH.D.
• William Craig Mitchell, M.D.
• James Samuel Mitchener III, MD
• Sandeep Mittal, MD FRCSC FACS
• Mizellore Medical Solutions LLC (MZL Prosthetics)
• MLB Medical Transport Services LLC
• Alysa V Modi
• Gay Carol Moffit, LPC
• David Ndikum Moffor, DNP, CRNA
• Aleem Tariq Mohamed

• Certified Registered Nurse Anesthetist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.