Individual provider Active NPI

Mason Crumrine, AGACNP

  • Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1851086888
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1112586 Issued in TX
Practice address
519 N Lincoln Ave
Odessa, TX 79761-4429
Phone
(432) 640-6446
Fax
(432) 640-6491
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1112586 TX
Nurse Practitioner 363L00000X 1112586 TX Primary
Acute Care Nurse Practitioner 363LA2100X 1112586 TX

Addresses

Primary practice location

519 N Lincoln Ave
Odessa, TX 79761-4429

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-6446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418001227 TX Practitioner - Nurse Practitioner 4082089388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional CareGroup PAC ID 1658358635, 51 clinicians

Practice addresses (Care Compare)

519 N Lincoln Ave
Odessa, TX 79761-4429
Phone (432) 640-6446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.78 of 100Reported as group
Quality
60.9
Promoting interoperability
100
Improvement activities
40
Cost
66.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1112586TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care CurrentSince Mar 28, 2023 Accepting new patients

Locations

519 N Lincoln Ave
Odessa, TX 79761
Phone (432) 640-6446

315 Golder Ave
Ste B
Odessa, TX 79761
Phone (432) 332-2695

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

Organizations & group practices 1

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1851086888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-6446",
            "fax_number": "432-640-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N LINCOLN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614429",
            "telephone_number": "432-640-6446",
            "fax_number": "432-640-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMRINE",
        "first_name": "MASON",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1112586",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1112586",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1112586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.