Individual provider Active NPI

Tracey Jay Krzanowski, MD

  • Anesthesiology Physician
  • Suffern, NY
National Provider Identifier
1154306637
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07935600 Issued in NJ
Practice address
100 Route 59
Suite 105
Suffern, NY 10901-4927
Phone
(845) 357-5775
Fax
(845) 357-5777
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07935600 NJ Primary

Addresses

Primary practice location

100 Route 59
Suite 105
Suffern, NY 10901-4927

Mailing address

100 Route 59
Suite 105
Suffern, NY 10901-4927
Phone (845) 357-5775

Other identifiers 1

IdentifierTypeStateIssuer
0088293MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000746 NJ Practitioner - Anesthesiology 1456373521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07935600NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Anesthesiology CurrentSince Apr 18, 2022 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients
Morris Anesthesia Group, PA Past Accepting new patients
Morris Anesthesia Group, PA Anesthesiology PastSince Mar 20, 2022 Accepting new patients
Rutherford Anesthesia Associates, LLC Anesthesiology Past Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1154306637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 105",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 105",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZANOWSKI",
        "first_name": "TRACEY",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07935600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088293",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.