Individual provider Active NPI

Melissa Liticia Crossette, CRNA

  • Certified Registered Nurse Anesthetist
  • Independence, MO
National Provider Identifier
1265700819
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2012001253 Issued in MO
Practice address
19600 E 39TH St S
Independence, MO 64057-2301
Phone
(316) 651-6689
NPI assigned
Dec 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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 2011036278 MO
Certified Registered Nurse Anesthetist 367500000X 2012001253 MO Primary

Addresses

Primary practice location

19600 E 39TH St S
Independence, MO 64057-2301

Mailing address

1600 N 2ND St
Clinton, MO 64735-1297
Phone (660) 885-5511

Other practice location 1

1600 N 2nd St
Clinton, MO 64735-1297
Phone (660) 885-5511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120410000481 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648431155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Valley Memorial Hospital DistrictGroup PAC ID 4688561814, 138 clinicians

Practice addresses (Care Compare)

1600 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-8171

Hospital & facility affiliations

  • Golden Valley Memorial Hospital Hospital, Clinton, MO, CCN 260175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Sep 26, 2022 Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Sep 26, 2022 Accepting new patients
Golden Valley Memorial Hospital District Current Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Mar 2, 2012 Accepting new patients

Locations

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

Organizations & group practices 4

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": "1323561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1265700819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351297",
            "telephone_number": "660-885-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572301",
            "telephone_number": "316-651-6689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N 2nd St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MO",
            "postal_code": "647351297",
            "country_code": "US",
            "telephone_number": "660-885-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSSETTE",
        "first_name": "MELISSA",
        "middle_name": "LITICIA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-11",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2011036278",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2012001253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.