Individual provider Active NPI

Jenine C Salisbury, CRNA

  • Certified Registered Nurse Anesthetist
  • Valhalla, NY
National Provider Identifier
1104905785
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
457065-1 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-7000
Fax
(914) 493-7927
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 457065-1 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other practice location 1

15 Maple Ave
Operating Room
Warwick, NY 10990-1028
Phone (845) 987-5130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100524000398 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527197920 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
457065-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Apr 11, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Current Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Nov 1, 2017 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

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

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

118 N Bedford Rd
Ste 200
Mount Kisco, NY 10549
Phone (800) 362-6220

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

15 Maple Ave
Warwick, NY 10990
Phone (845) 986-2224

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: jsalisbury198006@direct.optum.com

Organizations & group practices 5

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1104905785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7000",
            "fax_number": "914-493-7927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Maple Ave",
            "address_2": "Operating Room",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "NY",
            "postal_code": "109901028",
            "country_code": "US",
            "telephone_number": "845-987-5130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALISBURY",
        "first_name": "JENINE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "457065-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.