Marissa Lynette Commodore, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN264280 Issued in GA

Practice address

5357 Windfern CT
Stone Mountain, GA 30088-3329

Phone

(770) 875-3080

NPI assigned

Jun 28, 2021

Last updated

May 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Rockdale Anesthesia Services, P.C.Group PAC ID 4284536855, 32 clinicians

Regenerative Spine and Pain SpecialistsGroup PAC ID 2163851528, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
• Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FFEBCD

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.

• Piedmont Anesthesia LLC

  • Anesthesiology Physician
  • Stockbridge, GA
  • NPI 1700474244
  Medicare reassignment Care Compare group NPD
• Regenerative Spine and Pain Specialists

  • Interventional Pain Medicine Physician
  • Fayetteville, GA
  • NPI 1578193355
  Medicare reassignment Care Compare group NPD
• Rockdale Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Conyers, GA
  • NPI 1619028396
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Advanced Urology Anesthesia, LLC

  • Specialist
  • Snellville, GA
  • NPI 1215365242
  Medicare reassignment NPD
• Coastal Ambulatory Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1750753786
  Medicare reassignment NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment NPD
• Gi Anesthesia of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Gainesville, GA
  • NPI 1326569187

  Anesthesiology

  Medicare reassignment NPD
• Primary Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Fayetteville, GA
  • NPI 1427640317

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Advanced Urology Institute of Georgia, LLC

  • Urology Physician
  • Snellville, GA
  • NPI 1073896510
  NPD
• Advanced Urology Institute of Georgia, LLC

  • Urology Physician
  • Dallas, GA
  • NPI 1811846348
  NPD
• RSPS Fayetteville ASC LLC

  dba RSPS Fayetteville ASC

  • Ambulatory Surgical Clinic/Center
  • Fayetteville, GA
  • NPI 1750905618
  NPD (past)

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

• Crawford Long Hospital

  dba Emory University dba Emory Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation
• Piedmont Rockdale Hospital Inc.

  • General Acute Care Hospital
  • Conyers, GA
  • NPI 1306355680
  Care Compare affiliation

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1881264356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5357 WINDFERN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883329",
            "telephone_number": "770-875-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 WINDFERN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883329",
            "telephone_number": "770-875-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMMODORE",
        "first_name": "MARISSA",
        "middle_name": "LYNETTE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN264280",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "RN264280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakheem Collins
• Shanta Mitchell Collins, RN
• Terri R Collins
• Comfort Pharmacy Inc
• Comfort Pharmacy Inc (Comfort Pharmacy 2)
• Compassionate Hearts, LLC
• Complete Healthcare Management LLC
• Comprehensive Podiatry, LLC (Comprehensive Podiatry Clinic, LLC)
• Comprehensive Vine Health Services
• Theresa Comrie, RN

• Certified Registered Nurse Anesthetist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.