Individual provider Active NPI

Augustine Devita, CRNA

  • Certified Registered Nurse Anesthetist
  • Cherry Hill, NJ
National Provider Identifier
1114973930
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10192700 Issued in NJ
Practice address
408 Route 70 E
Cherry Hill, NJ 08034-2409
Phone
(215) 829-3867
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 10192700 NJ Primary

Addresses

Primary practice location

408 Route 70 E
Cherry Hill, NJ 08034-2409

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060331000096 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951329663 Reassigns benefits to 1 organization
I20111110000192 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951329663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10192700NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants, PC CurrentSince Dec 16, 2011 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC CurrentSince Jul 1, 2005 Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

408 Route 70 E
Cherry Hill, NJ 08034
Phone (267) 322-7700

301 S 8th St
Ste 2L
Philadelphia, PA 19106
Phone (215) 829-7260

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 2

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1114973930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 ROUTE 70 E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342409",
            "telephone_number": "215-829-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVITA",
        "first_name": "AUGUSTINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "10192700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.