Individual provider Active NPI

Eldine Ciceron

  • Certified Registered Nurse Anesthetist
  • Englewood, NJ
National Provider Identifier
1023747367
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ15372600 Issued in NJ
Practice address
350 Engle St
Englewood, NJ 07631-1808
Phone
(845) 821-0058
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 26NJ15372600 NJ Primary

Addresses

Primary practice location

350 Engle St
Englewood, NJ 07631-1808

Mailing address

83 Somerset Dr
Suffern, NY 10901-6905
Phone (845) 821-0058

Other practice location 1

97 W Parkway
Pompton Plains, NJ 07444-1647
Phone (862) 248-8263

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814003126 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870092166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Valley Anesthesiology PAGroup PAC ID 0749194868, 85 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 871-6073

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15372600NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Valley Anesthesiology, P.a. CurrentSince Aug 25, 2025 Accepting new patients
Columbia School of Nursing PastSince Jul 9, 2023 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

Organizations & group practices 2

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 1

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": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1023747367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SOMERSET DR",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109016905",
            "telephone_number": "845-821-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "845-821-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 W Parkway",
            "address_purpose": "LOCATION",
            "city": "Pompton Plains",
            "state": "NJ",
            "postal_code": "074441647",
            "country_code": "US",
            "telephone_number": "862-248-8263",
            "fax_number": "973-831-5318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICERON",
        "first_name": "ELDINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15372600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.