Individual provider Active NPI

Jason Fernandes, CRNA

  • Certified Registered Nurse Anesthetist
  • Troy, NY
National Provider Identifier
1093282279
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
839415 Issued in NY
Practice address
2215 Burdett Ave
Troy, NY 12180-2475
Phone
(518) 525-8600
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11000815 FL
Certified Registered Nurse Anesthetist 367500000X 839415 NY Primary

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180-2475

Mailing address

86 Providence LN
Palm Coast, FL 32164-4758
Phone (386) 503-8825

Other practice location 1

1000 36th St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190213000772 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193063337 Reassigns benefits to 3 organizations
I20210318001541 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193063337 Reassigns benefits to 1 organization
I20230901002074 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193063337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
39.78 of 100Reported as group
Quality
24.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000815FLMDCertified Registered Nurse Anesthetist
839415NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Physician Health, P.C. CurrentSince Jul 18, 2023 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 30, 2019 Accepting new patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2021 Accepting new patients
Indian River Health Services Inc CurrentSince Mar 15, 2020 Accepting new patients
Anesthesiology Professional Services, Inc. CurrentSince May 30, 2024 Accepting new patients
Indian River Health Services Inc CurrentSince Mar 15, 2020 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2333 W Hillsborough Ave
Ste 110
Tampa, FL 33603
Phone (813) 291-7014

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1000 36th St
Ste 244
Vero Beach, FL 32960
Phone (772) 778-9621

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1093282279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 PROVIDENCE LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321644758",
            "telephone_number": "386-503-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802475",
            "telephone_number": "518-525-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 36th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329604862",
            "country_code": "US",
            "telephone_number": "772-567-4311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "JASON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11000815",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "839415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.