Nancy E Misicko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101231419 Issued in VA

Practice address

150 Market Ridge Lane
Daleville, VA 24083

Phone

(540) 992-4100

Fax

(540) 992-6669

NPI assigned

Nov 4, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Family Practice

Education

Pennsylvania State University College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Roanoke, VA, CCN 497429
• Amedisys Home Health Care Home health agency, Roanoke, VA, CCN 497275
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmisicko17533@direct.carilionclinic.org

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.

• Carilion Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment Care Compare group NPD
• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment Care Compare group NPD
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD
• Carilion Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Home Health of Virginia Sub 2 LLC

  • Home Health Agency
  • Pulaski, VA
  • NPI 1164470738
  Care Compare affiliation
• Carilion Medical Center

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Roanoke, VA
  • NPI 1124059688
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1851382121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 STONELEA DR",
            "city": "TROUTVILLE",
            "state": "VA",
            "postal_code": "241757195",
            "telephone_number": "540-966-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARKET RIDGE LANE",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "24083",
            "telephone_number": "540-992-4100",
            "fax_number": "540-992-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISICKO",
        "first_name": "NANCY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101231419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5626315",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080178195",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5623332",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanesha L Love
• Kyle William Matyger, PHARMD
• Karen Maxwell, D.C.
• Jackson Thomas May
• Caitlin McGowan, CCC-SLP
• Robyn Bond Mitchell, COTA/L
• Cynthia Hackworth Moran, MA, CCC/SLP
• Moretti Family Chiropractic, LLC
• Moses Moretti, D.C.
• Bassel J Moughrabi, MD

• Family Medicine Physician in Daleville, VA
• Providers in Daleville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.