Individual provider Active NPI

Jennifer Rae Ambrose, CRNA

  • Certified Registered Nurse Anesthetist
  • Anchorage, AK
National Provider Identifier
1013147693
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101104 Issued in NE
Practice address
4100 Lake Otis Pkwy
Suite 222
Anchorage, AK 99508-5229
Phone
(612) 269-1918
NPI assigned
Jul 17, 2009
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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 101104 NE Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy
Suite 222
Anchorage, AK 99508-5229

Mailing address

16015 Sunset Bend Cir
Anchorage, AK 99516-7576
Phone (612) 269-1918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207003818 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365597770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

3209 S 23Rd St
Suite 200
Tacoma, WA 98405-1602
Phone (253) 272-5127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101104NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC CurrentSince Nov 21, 2023 Accepting new patients
Washington Gastroenterology PLLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Paceline Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 15, 2023 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Nov 21, 2023 Accepting new patients
Alaska Spine Center, LLC Past Accepting new patients
Creighton University Past Accepting new patients
Professional Anesthesia Services LLP Past Accepting new patients
Creighton University Past Accepting new patients

Locations

1135 116th Ave NE
Ste 400
Bellevue, WA 98004
Phone (425) 454-4644

1135 116th Ave NE
Ste 570
Bellevue, WA 98004
Phone (425) 451-7335

1135 116th Ave NE
Ste NE560
Bellevue, WA 98004

1900 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 330-8627

12800 Bothell Everett Hwy
Ste 200
Everett, WA 98208
Phone (206) 259-3122

2727 Hollycroft St
Ste 380
Gig Harbor, WA 98335
Phone (253) 858-0112

5801 Soundview Dr
Ste 156
Gig Harbor, WA 98335
Phone (253) 514-6216

1301 4th Ave NW
Ste 301
Issaquah, WA 98027
Phone (425) 270-6363

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

2100 Little Mountain Ln
Mount Vernon, WA 98274
Phone (360) 416-6735

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

1101 Madison St
Ste 400
Seattle, WA 98104
Phone (206) 505-1230

3209 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (253) 503-2508

Organizations & group practices 8

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1013147693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16015 SUNSET BEND CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995167576",
            "telephone_number": "612-269-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY",
            "address_2": "SUITE 222",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085229",
            "telephone_number": "612-269-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.