Individual provider Active NPI

Sarah Y Pucek, CRNA

  • Anesthesiology Physician
  • Jackson, TN
National Provider Identifier
1164676177
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
APN0000011444 Issued in TN
Practice address
131 Tucker St
Suite 5
Jackson, TN 38301-4055
Phone
(931) 388-6404
NPI assigned
Nov 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X APN0000011444 TN Primary
Anesthesiology Physician 207L00000X RN0000084350 TN

Addresses

Primary practice location

131 Tucker St
Suite 5
Jackson, TN 38301-4055

Mailing address

131 Tucker St
Suite 5
Jackson, TN 38301-4055
Phone (931) 388-6404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090508000218 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072661628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000011444TNMDAnesthesiology Physician
RN0000084350TNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Anesthesia & Perioperative Consultants P C Anesthesiology Past Accepting new patients
Jackson Clinic PA Anesthesiology PastSince Jan 3, 1995 Accepting new patients
Professional Anesthesia Associates Anesthesiology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1164676177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 TUCKER ST",
            "address_2": "SUITE 5",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014055",
            "telephone_number": "931-388-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 TUCKER ST",
            "address_2": "SUITE 5",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014055",
            "telephone_number": "931-388-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCEK",
        "first_name": "SARAH",
        "middle_name": "Y",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "APN0000011444",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "RN0000084350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.