Jacqueline Botkin, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

630478 Issued in NY

Practice address

622 W 168TH St
New York, NY 10032-3720

Phone

(212) 305-9878

Fax

(212) 305-8980

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jbotkin188852@orlandohealth.medalliesdirect.net

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.

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Trustees of Columbia University in the City of New York

  • Anesthesiology Physician
  • New York, NY
  • NPI 1841239829

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Ohio Post-Acute Medical Services 1 Inc

  • Family Medicine Physician
  • Englewood, OH
  • NPI 1215475199
  NPD (past)
• Tmhpo Orthopedics Department

  • Orthopaedic Trauma Physician
  • Houston, TX
  • NPI 1497795272
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1053536938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTKIN",
        "first_name": "JACQUELINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2017052",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "630478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "ARNP2017052",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "100496",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430054530",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "13181",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP OF FL",
            "identifier": "212334",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Botero-Mondul, D.D.S
• Cristina Margarita Botero, NP
• Gina P Botero
• Lauren Kristen Botero, MD
• Regina A Bothwell, MS
• Deborah Christine Botnick-Basile, PSY.D.
• Heidi L. Botnick, L.AC.
• Fady Botros, MD
• Mohraiel Botros
• Samuel M Botros, PHARM.D

• Certified Registered Nurse Anesthetist in New York, NY
• Providers in New York, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.