Individual provider Active NPI

Jennifer Lynn Mahedy, CRNA

  • Certified Registered Nurse Anesthetist
  • Newburgh, NY
National Provider Identifier
1053748699
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
93724 Issued in NY
Practice address
70 Dubois Street
St Lukes Hospital
Newburgh, NY 12550
Phone
(845) 561-4400
NPI assigned
Sep 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 553704 NY
Registered Nurse 163W00000X 553704-1 NY
Certified Registered Nurse Anesthetist 367500000X 93724 NY Primary

Addresses

Primary practice location

70 Dubois Street
St Lukes Hospital
Newburgh, NY 12550

Mailing address

109 Denniston Drive
New Windsor, NY 12553
Phone (845) 779-2804

Other names 1

  • Ms. Jennifer Lynn Vazquez Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140408002047 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204068141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Albany Medical College of Union University, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
553704NYMDRegistered Nurse
553704-1NYMDRegistered Nurse
93724NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Nov 1, 2017 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Sep 14, 2019 Accepting new patients
Albany Medical College CurrentSince Dec 19, 2013 Accepting new patients
Albany Medical College Nurse Anesthetist, Certified Registered CurrentSince Dec 19, 2013 Accepting new patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

111 E 210th St
Bronx, NY 10467

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

95 Crystal Run Rd
Middletown, NY 10941
Phone (845) 703-3800

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Networks

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

Organizations & group practices 7

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": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1053748699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DENNISTON DRIVE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "12553",
            "telephone_number": "845-779-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DUBOIS STREET",
            "address_2": "ST LUKES HOSPITAL",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "12550",
            "telephone_number": "845-561-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHEDY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "553704",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "553704-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "93724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VAZQUEZ",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.