Individual provider Active NPI

Samantha Offenback

  • Certified Registered Nurse Anesthetist
  • Pennington, NJ
National Provider Identifier
1063150902
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NR18699700 Issued in NJ
Practice address
1 Capital Way
Pennington, NJ 08534-2520
Phone
(800) 637-2374
NPI assigned
May 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 26NR18699700 NJ
Certified Registered Nurse Anesthetist 367500000X 26NR18699700 NJ Primary

Addresses

Primary practice location

1 Capital Way
Pennington, NJ 08534-2520

Mailing address

7 Moonlight Way
Howell, NJ 07731-4032
Phone (609) 346-6948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818001399 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557744885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR18699700NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC CurrentSince Jul 1, 2022 Accepting new patients

Locations

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1063150902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MOONLIGHT WAY",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077314032",
            "telephone_number": "609-346-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520",
            "telephone_number": "800-637-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFENBACK",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18699700",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR18699700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.