Individual provider Active NPI

Maria Lynn McCrackin, M.D.

  • Anesthesiology Physician
  • Sacramento, CA
National Provider Identifier
1316479306
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A159134 Issued in CA
Practice address
4150 V St
#1200
Sacramento, CA 95817-1460
Phone
(916) 734-5028
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A159134 CA Primary

Addresses

Primary practice location

4150 V St
#1200
Sacramento, CA 95817-1460

Mailing address

4150 V St
#1200
Sacramento, CA 95817-1460
Phone (815) 519-1550

Other names 1

  • Maria Lynn Nellessen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnellessen@ucdavis.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210527003010 CA Practitioner - Anesthesiology 0749689560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Michigan Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2657

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A159134CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Single Specialty Current Accepting new patients
Regents of the University of Ca Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Regents of the Univ of Ca Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Single Specialty Past Accepting new patients

Locations

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

Organizations & group practices 5

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1316479306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "815-519-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKIN",
        "first_name": "MARIA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A159134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnellessen@ucdavis.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4150 V St",
            "address_2": "#1200",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958171460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "NELLESSEN",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.