Individual provider Active NPI

Jessica Lynn Novak, CRNA

  • Certified Registered Nurse Anesthetist
  • Saranac Lake, NY
National Provider Identifier
1023651304
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
786233 Issued in NY
Practice address
2233 State Route 86
Saranac Lake, NY 12983-5644
Phone
(518) 891-4141
NPI assigned
Oct 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 103163453102 UT
Certified Registered Nurse Anesthetist 367500000X 786233 NY Primary

Addresses

Primary practice location

2233 State Route 86
Saranac Lake, NY 12983-5644

Mailing address

731 S Douglas St
Salt Lake City, UT 84102-3717
Phone (201) 248-1689

Other names 1

  • Jessica Lynn Karl Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000974 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446688758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 891-4141

Hospital & facility affiliations

  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103163453102UTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of New York, P.C. Nurse Anesthetist, Certified Registered CurrentSince Feb 24, 2020 Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1023651304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S DOUGLAS ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023717",
            "telephone_number": "201-248-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-891-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-19",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "103163453102",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "786233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KARL",
            "middle_name": "LYNN",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saranac Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.