Individual provider Active NPI

Marissa Nicole Simon, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Chesapeake, VA
National Provider Identifier
1760066450
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
136180 Issued in VA
Practice address
732 Eden Way N # 534
Chesapeake, VA 23320-2798
Phone
(757) 828-4259
NPI assigned
May 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 136180 VA Primary

Addresses

Primary practice location

732 Eden Way N # 534
Chesapeake, VA 23320-2798

Mailing address

732 Eden Way N # 534
Chesapeake, VA 23320-2798
Phone (757) 828-4259

Other practice location 1

134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0044

Other practice location 2

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624000929 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638570955 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians
Atlantic Anesthesia, IncGroup PAC ID 4587562152, 177 clinicians

Practice addresses (Care Compare)

1031 Loftis Blvd
Newport News, VA 23606-2981
Phone (757) 736-9898

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 473-0055

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.76 of 100Reported as group
Quality
78.69
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136180VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC CurrentSince Nov 1, 2022 Accepting new patients
SMG Anesthesia Specialists LLC CurrentSince Feb 17, 2022 Accepting new patients
Atlantic Anesthesia, Inc CurrentSince Jul 18, 2022 Accepting new patients
Goodwin & Snyder Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
Ambulatory Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

844 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6746

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

241 Corporate Blvd
Norfolk, VA 23502
Phone (757) 362-3577

3920A Bridge Rd
Suffolk, VA 23435
Phone (757) 983-0000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

134 Business Park Dr
Virginia Beach, VA 23462
Phone (757) 473-0044

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

5215 Monticello Ave
Williamsburg, VA 23188
Phone (757) 229-4000

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": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1760066450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 EDEN WAY N # 534",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202798",
            "telephone_number": "757-828-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 EDEN WAY N # 534",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202798",
            "telephone_number": "757-828-4259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Business Park Dr",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234626523",
            "country_code": "US",
            "telephone_number": "757-473-0044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Gresham Dr",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MARISSA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "136180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.