Individual provider Active NPI

Jennifer J Wang, CRNA

  • Certified Registered Nurse Anesthetist
  • Santa Monica, CA
National Provider Identifier
1225420284
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
105362 Issued in CA
Practice address
3019 Ocean Park Blvd Unit 358
Santa Monica, CA 90405-3004
Phone
(310) 795-5988
NPI assigned
Feb 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 105362 CA Primary

Addresses

Primary practice location

3019 Ocean Park Blvd Unit 358
Santa Monica, CA 90405-3004

Mailing address

3019 Ocean Park Blvd Unit 358
Santa Monica, CA 90405-3004
Phone (310) 795-5988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180207000904 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163782400 Reassigns benefits to 2 organizations
I20220825003016 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163782400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wang Anesthesia Nursing Management IncGroup PAC ID 7214261429, 4 clinicians

Practice addresses (Care Compare)

4738 La Villa Marina
Unit K
Marina del Rey, CA 90292-7030
Phone (909) 608-1123

6958 S Ensenada CT
Centennial, CO 80016-1964
Phone (310) 795-8503

Merit-based Incentive Payment System (MIPS)

Final score
74.04 of 100Reported as group
Quality
48.8
Promoting interoperability
98
Improvement activities
40
Cost
66.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105362CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Anesthesia Group, PLLC CurrentSince Jan 30, 2023 Accepting new patients
Tower Anesthesia Associates Inc CurrentSince May 20, 2019 Accepting new patients
Denver Digestive Health Specialists Inc CurrentSince Aug 1, 2022 Accepting new patients
Wang Anesthesia Nursing Management Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 21, 2019 Accepting new patients
Colorado Gastroenterology Prof LLC PastSince Feb 19, 2024 Accepting new patients

Locations

9090 Wilshire Blvd
Ste 101
Beverly Hills, CA 90211
Phone (310) 421-0066

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

4712 Admiralty Way
Unit 170
Marina del Rey, CA 90292
Phone (213) 245-1563

3019 Ocean Park Blvd
Santa Monica, CA 90405
Phone (310) 270-5307

8155 E 1st Ave
Denver, CO 80230
Phone (303) 344-4844

4500 E 9th Ave
Ste 720S
Denver, CO 80220
Phone (303) 355-3525

10520 El Diente Ct
Englewood, CO 80112
Phone (720) 248-0797

10520 El Diente Ct
Ste A
Englewood, CO 80112
Phone (720) 414-5310

Organizations & group practices 5

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": "1425081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1225420284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD UNIT 358",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "310-795-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD UNIT 358",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "310-795-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-28",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "105362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

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