Individual provider Active NPI

Mary A. Allegro, CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1861434474
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN186985 Issued in OH
Practice address
8401 Market St
Youngstown, OH 44512-6725
Phone
(330) 286-5330
Fax
(330) 286-5396
NPI assigned
Jun 11, 2006
Last updated
Nov 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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 RN186985 OH Primary

Addresses

Primary practice location

8401 Market St
Youngstown, OH 44512-6725

Mailing address

4135 Boardman Canfield Rd
Suite 101
Canfield, OH 44406-9803
Phone (330) 286-5330

Other practice location 1

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 286-5330

Other identifiers 4

IdentifierTypeStateIssuer
8236361OtherOHMEDICARE PTAN
106911TV6OtherPAMEDICARE PTAN
P00276725OtherOHMEDICARE RAILROAD
2617832MedicaidOH

Other names 1

  • Mary A. Derose Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191209000746 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466473293 Reassigns benefits to 2 organizations
I20241029000316 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466473293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Ohio Sedation Associates LLCGroup PAC ID 3779848684, 12 clinicians

Practice addresses (Care Compare)

75 Sylvania Dr
Beavercreek, OH 45440-3237
Phone (937) 320-5050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN186985OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Austin Gastroenterology Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2019 Accepting new patients
Western Ohio Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 14, 2024 Accepting new patients
McCandless Endoscopy Center, LLC Past Accepting new patients

Locations

75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

4310 James Casey St
Ste 4B
Austin, TX 78745
Phone (512) 407-8444

8015 Shoal Creek Blvd
Austin, TX 78757
Phone (512) 971-1519

8015 Shoal Creek Blvd
Ste 300
Austin, TX 78757
Phone (512) 371-1519

3944 Ranch Road 620 S
Ste 103
Bee Cave, TX 78738
Phone (512) 371-1519

3030 S Gessner Rd
Ste 150
Houston, TX 77063
Phone (713) 587-0909

8550 Datapoint Dr
Ste 100
San Antonio, TX 78229
Phone (210) 615-7232

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1861434474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126725",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEGRO",
        "first_name": "MARY",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN186985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8236361",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "106911TV6",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00276725",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2617832",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DEROSE",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.