Jennifer Park Severenko

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

12.008590 Issued in CT

Practice address

24 Hospital Ave
Danbury, CT 06810-6099

Phone

(203) 739-7118

Fax

(203) 749-9030

NPI assigned

Feb 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Bridgeport Anesthesia Associates, P.C.Group PAC ID 7113824616, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Danbury Hospital Hospital, Danbury, CT, CCN 070033

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Bridgeport Anesthesia Associates, P.C.

  • Anesthesiology Physician
  • Bridgeport, CT
  • NPI 1174549257

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Anesthesiology, PC

  • Anesthesiology Physician
  • Chappaqua, NY
  • NPI 1417401266

  CT

  Medicare reassignment Care Compare group NPD
• Anesthesiologists of Middletown, P.C.

  • Anesthesiology Physician
  • Middletown, CT
  • NPI 1851317135
  Medicare reassignment NPD

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

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1013474261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7118",
            "fax_number": "203-749-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7118",
            "fax_number": "203-749-9030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Yorktown Heights",
            "state": "NY",
            "postal_code": "105982621",
            "country_code": "US",
            "telephone_number": "516-582-9754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERENKO",
        "first_name": "JENNIFER",
        "middle_name": "PARK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "12.008590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Serrins, M.D.
• Juliana G Servetnick, LMSW
• Service Aides, Inc.
• Amy Noelle Setesak, RN
• Sakshi Sethi, MD
• Martha Severino, MD
• William Keith Shafto, PA-C
• Abhijit Shah
• Drishti Nimesh Shah, M.D.
• Imam Ali Shah, MBBS

• Certified Registered Nurse Anesthetist in Danbury, CT
• Providers in Danbury, CT by specialty
• Certified Registered Nurse Anesthetist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.