Individual provider Active NPI

Jason J Westra, CRNA

  • Certified Registered Nurse Anesthetist
  • Southampton, NY
National Provider Identifier
1114213501
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
597211 Issued in NY
Practice address
265 Herrick Rd
Southampton, NY 11968-5045
Phone
(631) 726-8350
Fax
(631) 726-8519
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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 597211 NY
Registered Nurse 163W00000X 088571 CT
Certified Registered Nurse Anesthetist 367500000X 597211 NY Primary

Addresses

Primary practice location

265 Herrick Rd
Southampton, NY 11968-5045

Mailing address

PO Box 7025
Amagansett, NY 11930-7025
Phone (631) 329-6925

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110706000502 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517145949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Hospital & facility affiliations

  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088571CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2024 Accepting new patients
Long Island Digestive Endoscopy Center, LLC CurrentSince Feb 5, 2024 Accepting new patients
New York University CurrentSince Jul 1, 2024 Accepting new patients
New York University Current Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Aug 2, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

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

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

27005 76th Ave
North New Hyde Pk, NY 11040

1500 Route 112
Bldg 5
Port Jefferson Station, NY 11776
Phone (631) 470-1450

Networks

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

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.

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1114213501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7025",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119307025",
            "telephone_number": "631-329-6925",
            "fax_number": "631-329-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 HERRICK RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685045",
            "telephone_number": "631-726-8350",
            "fax_number": "631-726-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTRA",
        "first_name": "JASON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "597211",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "088571",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "597211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.