Individual provider Active NPI

Anne Marie Micikas, CRNA

  • Certified Registered Nurse Anesthetist
  • Melville, NY
National Provider Identifier
1306867684
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN198985L Issued in PA
Practice address
68 S Service Rd
Suite 350
Melville, NY 11747-2354
Phone
(516) 945-3115
Fax
(516) 945-3131
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN198985L PA Primary

Addresses

Primary practice location

68 S Service Rd
Suite 350
Melville, NY 11747-2354

Mailing address

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 829-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040910001160 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416924337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Anesthesia PLLCGroup PAC ID 5991184863, 112 clinicians

Practice addresses (Care Compare)

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 829-8111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2011 Accepting new patients

Locations

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

700 Quincy Ave
Scranton, PA 18510
Phone (570) 340-2100

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Organizations & group practices 2

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 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1306867684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187640999",
            "telephone_number": "570-829-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD",
            "address_2": "SUITE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472354",
            "telephone_number": "516-945-3115",
            "fax_number": "516-945-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICIKAS",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN198985L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.