Individual provider Active NPI

Emily Mardakis, CRNA

  • Certified Registered Nurse Anesthetist
  • Roanoke, VA
National Provider Identifier
1790050839
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024169973 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014
Phone
(540) 853-0222
Fax
(540) 981-7855
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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 0024169973 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014

Mailing address

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 853-0222

Other practice location 1

500 Medical Center Blvd
Webster, TX 77598-4220
Phone (281) 332-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131029001838 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668638636 Reassigns benefits to 4 organizations
I20220928000287 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668638636 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
Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

5115 Bernard Dr
Suite 201
Roanoke, VA 24018-4367
Phone (540) 345-0289

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024169973VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Radford Inc CurrentSince Jan 19, 2014 Accepting new patients
Acv Inc CurrentSince Aug 2, 2023 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Aug 1, 2022 Accepting new patients
Valley Anesthesia PC CurrentSince Aug 1, 2020 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Aug 1, 2022 Accepting new patients
Inova Cares - Community CurrentSince Jun 12, 2023 Accepting new patients
Anesthesiology Consultants of Virginia, Inc PastSince Aug 2, 2023 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

2900 Tyler Rd
Christiansburg, VA 24073
Phone (540) 731-7311

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

5115 Bernard Dr
Ste 201
Roanoke, VA 24018
Phone (540) 345-0289

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1790050839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "24014",
            "telephone_number": "540-853-0222",
            "fax_number": "540-981-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984220",
            "country_code": "US",
            "telephone_number": "281-332-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARDAKIS",
        "first_name": "EMILY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.