Individual provider Active NPI

Anna Tchoudovskaia, RN, CRNA, DNAP

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1154690329
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
88325 Issued in NY
Practice address
1275 York Ave
Department of Anesthesiology
New York, NY 10065-6007
Phone
(212) 639-6840
NPI assigned
Dec 17, 2011
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 88325 NY Primary
Registered Nurse 163W00000X 651902-1 NY

Addresses

Primary practice location

1275 York Ave
Department of Anesthesiology
New York, NY 10065-6007

Mailing address

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-6840

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2475
Phone (518) 525-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000844 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628236163 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
651902-1NYMDRegistered Nurse
88325NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Physician Health, P.C. CurrentSince Feb 15, 2024 Accepting new patients
Memorial Anesthesiology Group Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2012 Accepting new patients
Centurion Midtown Anesthesia PLLC CurrentSince Jan 31, 2025 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Mar 9, 2024 Accepting new patients

Locations

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

11129 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-8900

8745 Lake Street Rd
Le Roy, NY 14482
Phone (585) 267-7570

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

305 E 47th St
New York, NY 10017
Phone (212) 203-8744

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1324080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1154690329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802475",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TCHOUDOVSKAIA",
        "first_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "RN, CRNA, DNAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-17",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "88325",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "651902-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.