Individual provider Active NPI

Jeri Poor, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1124439971
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
616605-1 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 299-5451
Fax
(855) 851-4405
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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 616605-1 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

PO Box 535750
Atlanta, GA 30353-5510
Phone (866) 507-5244

Other names 1

  • Jeri Polchlopek Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150216001587 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618292632 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Albany Medical College of Union University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians
Upstate Medical Anesthesiology Group IncGroup PAC ID 8921992389, 76 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 498-6200

5000 Campuswood Dr
Suite 100
East Syracuse, NY 13057-1254
Phone (315) 234-6677

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4720

Merit-based Incentive Payment System (MIPS)

Final score
99.42 of 100Reported as group
Quality
97.55
Promoting interoperability
100
Improvement activities
40
Cost
82.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
616605-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP CurrentSince Mar 1, 2021 Accepting new patients
Oswego Hospital CurrentSince Feb 15, 2016 Accepting new patients
Syracuse Gastroenterological Associates PC CurrentSince Dec 12, 2025 Accepting new patients
Upstate Medical Anesthesiology Group, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Chag Anesthesia PC CurrentSince Jul 11, 2025 Accepting new patients
Griffiss Ec, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 4, 2021 Accepting new patients
Syracuse Gastroenterological Associates.PC Current Accepting new patients
Oswego Hospital CurrentSince Feb 15, 2016 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

5000 Campuswood Dr
Ste 100
East Syracuse, NY 13057
Phone (315) 234-6687

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

105 Dart Cir
Rome, NY 13441
Phone (315) 334-6918

5784 Widewaters Pkwy
Ste 2
Syracuse, NY 13214
Phone (315) 469-1134

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1124439971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303535510",
            "telephone_number": "866-507-5244",
            "fax_number": "954-858-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-299-5451",
            "fax_number": "855-851-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR",
        "first_name": "JERI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "616605-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERI",
            "last_name": "POLCHLOPEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.