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MARK MIZUBA CRNA
NPI 1164439899
Nurse Anesthetist, Certified Registered in Roanoke, VA

Active since August 02, 2006Accepts Medicare Assignment
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014(540) 853-0222(540) 981-7855 Get Directions Write a Review

NPPES record last updated: December 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mark Mizuba Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK MIZUBA CRNA (NPI 1164439899) is an individual nurse anesthetist, certified registered in Roanoke, Virginia, licensed in Virginia (0024166707) and active in the NPI registry since August 2006. He is affiliated with Carilion Franklin Memorial Hospital, maintains a secondary practice location in Salem, and is a graduate of University Of Pittsburgh School Of Medicine (1992).

NPPES Registry Identity

NPI1164439899
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMARK MIZUBACredential: CRNA
Location Address1906 BELLEVIEW AVE SERoanoke, VA 24014-1838
Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713
Phone(540) 853-0222
Fax(540) 981-7855
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1992
Enumeration DateAugust 2, 2006
Last NPPES UpdateDecember 22, 2025
NPPES CertifiedDecember 22, 2025
✔ NPI 1164439899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in VA · 0024166707
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1906 BELLEVIEW AVE SE, Roanoke, VA 24014
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Secondary Practice Location 1

Location 11970 Roanoke BlvdSalem, VA 24153-6404 · Phone (540) 982-2463 ext. 2250 · Fax (540) 983-1090

Other Identifiers 5

Medicaid010218608VA
Medicaid010218641VA
Medicaid010218632VA
Medicaid010218705VA
Medicaid010218748VA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark Mizuba Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800811100
PECOS Enrollment IDI20051228000462

Medicare Billing Reassignment

Medicare enrollment records show Mark Mizuba reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carilion Professional Services LLC
1.4 mi
Nurse Anesthetist, Certified Registered
213 S JEFFERSON ST, SUITE 801
Roanoke, VA 24011
  • Reassigned Medicare billing, Virginia enrollment
  • 140 clinicians in this Medicare group
NPI 1184634156 (540) 224-5125

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carilion Franklin Memorial Hospital

Acute Care Hospitals · Rocky Mount, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490089
Location180 Floyd AvenueRocky Mount, VA 24151 · Franklin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24014 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN K THOMPSON PA-C, ATC
Physician Assistant
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. JAMES LIGHT MD
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
SUJINA PRADHAN M.D.
Family Medicine
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. SAMMY ZAKI ELSARRAG M.D.
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NIMA JAHROMI DO
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
TAYLOR ALEXIS KEYS
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NATHAN WILLIAM WAKEFIELD
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
ASHLYN BROOKE CONRAD
Nurse Practitioner
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Mizuba's NPI number?

The NPI number for Mark Mizuba is 1164439899. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Where is Mark Mizuba located?

Mark Mizuba practices at 1906 Belleview Ave SE, Roanoke, VA 24014. The listed phone number is (540) 853-0222.

What is Mark Mizuba's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Mark Mizuba enrolled in Medicare?

Yes. Mark Mizuba is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Mark Mizuba's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Mizuba reassigns Medicare benefits to Carilion Professional Services LLC (Roanoke, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Mizuba's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Mark Mizuba affiliated with any hospitals?

According to CMS data, Mark Mizuba is affiliated with Carilion Franklin Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mark Mizuba was last updated on December 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.