Individual provider Active NPI

Jeremy Joseph Ortolona, CRNA

  • Certified Registered Nurse Anesthetist
  • Monongahela, PA
National Provider Identifier
1245562297
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN526595L Issued in PA
Practice address
1163 Country Club Rd
Monongahela, PA 15063-1013
Phone
(724) 258-1000
Fax
(724) 258-1364
NPI assigned
Feb 2, 2010
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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 RN526595L PA Primary

Addresses

Primary practice location

1163 Country Club Rd
Monongahela, PA 15063-1013

Mailing address

1163 Country Club Rd
Monongahela, PA 15063-1013
Phone (724) 258-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000146 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537296785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1163 Country Club Rd
Monongahela, PA 15063-1013
Phone (724) 258-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN526595LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mon Vale Clinical Professionals, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Mon Vale Clinical Professionals, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Fayette Anesthesia Providers Past Accepting new patients
Monongahela Valley Hospital, Inc. Past Accepting new patients

Locations

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

1163 Country Club Rd
#88
Monongahela, PA 15063
Phone (724) 258-1000

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 3

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": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1245562297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631013",
            "telephone_number": "724-258-1000",
            "fax_number": "724-258-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631013",
            "telephone_number": "724-258-1000",
            "fax_number": "724-258-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTOLONA",
        "first_name": "JEREMY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN526595L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.