Individual provider Active NPI

Jacob T. Navarro, CRNA

  • Certified Registered Nurse Anesthetist
  • Arlington, VA
National Provider Identifier
1174890438
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001202139 Issued in VA
Practice address
1701 N George Mason Dr
Suite 2D
Arlington, VA 22205-3610
Phone
(703) 558-5000
Fax
(517) 787-1027
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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 RN1016945 DC
Certified Registered Nurse Anesthetist 367500000X 0001202139 VA Primary

Addresses

Primary practice location

1701 N George Mason Dr
Suite 2D
Arlington, VA 22205-3610

Mailing address

1701 N George Mason Dr
Suite 2D
Arlington, VA 22205-3610
Phone (703) 558-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807003742 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375704604 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001202139VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Raleigh Sedation Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Jul 15, 2023 Accepting new patients

Locations

1500 Concord Ter
Fl 5
Sunrise, FL 33323
Phone (954) 384-0175

1505 SW Cary Pkwy
Ste 202
Cary, NC 27511
Phone (919) 249-5087

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

2417 Atrium Dr
Ste 101
Raleigh, NC 27607
Phone (919) 249-5216

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

8300 Health Park
Ste 210
Raleigh, NC 27615
Phone (919) 249-5902

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.

Hospital & facility affiliations 1

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1174890438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR",
            "address_2": "SUITE 2D",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "703-558-5000",
            "fax_number": "517-787-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR",
            "address_2": "SUITE 2D",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "703-558-5000",
            "fax_number": "517-787-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRO",
        "first_name": "JACOB",
        "middle_name": "T.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DC",
            "license": "RN1016945",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001202139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.