Individual provider Active NPI

Jason Mark Bennett

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1215575444
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
128442 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1899
Phone
(315) 448-5111
NPI assigned
Dec 18, 2019
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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 128442 NY Primary
Registered Nurse 163W00000X 676671-1 NY

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1899

Mailing address

1286 Harmony Rd
Susquehanna, PA 18847-7633
Phone (570) 396-1292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200421001842 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042640765 Reassigns benefits to 1 organization
I20240131000626 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042640765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnes-Kasson County HospitalGroup PAC ID 1355318635, 12 clinicians

Practice addresses (Care Compare)

2872 Turnpike St
Susquehanna, PA 18847-2771
Phone (570) 853-3135

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
676671-1NYMDRegistered Nurse
128442NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP CurrentSince Mar 1, 2021 Accepting new patients
Barnes-Kasson County Hospital CurrentSince Jan 1, 2024 Accepting new patients
Barnes-Kasson County Hospital CurrentSince Jan 1, 2024 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Aug 1, 2023 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

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

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

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

2872 Turnpike St
Susquehanna, PA 18847
Phone (570) 853-3135

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": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1215575444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 HARMONY RD",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188477633",
            "telephone_number": "570-396-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031899",
            "telephone_number": "315-448-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JASON",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "128442",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "676671-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 6, 2020; 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.