Individual provider Active NPI

Caresse Rose Correa, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Coram, NY
National Provider Identifier
1023714201
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
135327 Issued in NY
Practice address
19 Marla Dr
Coram, NY 11727-2723
Phone
(631) 599-0422
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 676731 NY
Certified Registered Nurse Anesthetist 367500000X 135327 NY Primary

Addresses

Primary practice location

19 Marla Dr
Coram, NY 11727-2723

Mailing address

19 Marla Dr
Coram, NY 11727-2723

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131002440 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971956418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135327NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Anesthesia Physicians LLP CurrentSince Jan 8, 2024 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
New York University Current Accepting new patients

Locations

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

Organizations & group practices 4

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": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1023714201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MARLA DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MARLA DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272723",
            "telephone_number": "631-599-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "CARESSE",
        "middle_name": "ROSE",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "676731",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "135327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.