Individual provider Active NPI

Jeannette A Blaha, CRNA

  • Certified Registered Nurse Anesthetist
  • Rocky Point, NY
National Provider Identifier
1104917491
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
423503 Issued in NY
Practice address
333 Route 25a Ste 225
Rocky Point, NY 11778-8802
Phone
(631) 744-3671
NPI assigned
Sep 28, 2006
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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 423503-1 NY
Certified Registered Nurse Anesthetist 367500000X 423503 NY Primary

Addresses

Primary practice location

333 Route 25a Ste 225
Rocky Point, NY 11778-8802

Mailing address

333 Route 25a Ste 225
Rocky Point, NY 11778-8802
Phone (631) 744-3671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060109000941 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537182258 Reassigns benefits to 2 organizations
I20240403000956 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537182258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
State University of Ny Upstate Medical University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Anesthesia Associates PAGroup PAC ID 6305825894, 34 clinicians

Practice addresses (Care Compare)

18941 John J Williams Hwy
Southern Delaware Surgery Center
Rehoboth Beach, DE 19971-4404
Phone (302) 644-6992

19161 Healthy Way
Rehoboth Beach, DE 19971-4491
Phone (302) 645-3300

424 Savannah Rd
Lewes, DE 19958-1462
Phone (302) 441-1078

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
423503-1NYMDRegistered Nurse
423503NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. Current Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Aug 20, 2018 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Delaware Anesthesia Associates, PA CurrentSince Feb 28, 2024 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Sep 1, 2024 Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Mar 1, 2014 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

424 Savannah Rd
Lewes, DE 19958
Phone (302) 441-1078

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

404 Potter Blvd
Brightwaters, NY 11718
Phone (631) 376-0055

560 Northern Blvd
Ste 203
Great Neck, NY 11021
Phone (516) 482-0600

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

2001 Marcus Ave
Ste N18
New Hyde Park, NY 11042
Phone (516) 775-7770

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

1110 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 476-9100

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

Interoperability endpoints

  • Direct secure messaging: jeannette.blaha1@direct.stonybrookmedicine.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1104917491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A STE 225",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788802",
            "telephone_number": "631-744-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A STE 225",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788802",
            "telephone_number": "631-744-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHA",
        "first_name": "JEANNETTE",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "423503-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "423503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.