Kyungmoon Roh, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

680524 Issued in NY

Practice address

30 Prospect Ave
Hackensack, NJ 07601-1915

Phone

(551) 996-2419

NPI assigned

Mar 1, 2022

Last updated

Sep 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Icahn School of Medicine at Mount SinaiGroup PAC ID 4385924091, 169 clinicians

Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
• Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100
• New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• New Jersey Healthcare Specialists PC

  • Anesthesiology Physician
  • Hackensack, NJ
  • NPI 1174585780
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Doctors GNY Anes Serv

  • Anesthesiology Physician
  • New York, NY
  • NPI 1447008446

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Weill Medical College of Cornell

  dba Nyph / WCMC Crna's

  • Certified Registered Nurse Anesthetist
  • New York, NY
  • NPI 1164768305

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Prime Healthcare Services - St. Mary's Passaic, LLC

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1730508250
  Medicare reassignment NPD
• Centurion Midtown Anesthesia PLLC

  • Anesthesiology Physician
  • New York, NY
  • NPI 1750087854
  Medicare reassignment NPD
• Prime Healthcare Services - St. Mary's Passaic LLC

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1770901761
  NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  dba Hackensack University Medical Center

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation
• New York Eye & Ear Infirmary

  • Special Hospital
  • New York City, NY
  • NPI 1245251222
  Care Compare affiliation
• New York Hospital Queens Ambulance

  • Land Ambulance
  • Flushing, NY
  • NPI 1295857092

  Hospital

  Care Compare affiliation
• New York-Presbyterian-Queens

  dba NYP-Queens Diagnostic Lab

  • Clinical Medical Laboratory
  • Flushing, NY
  • NPI 1053429274

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  dba Transitional Care Unit

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1689958779

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1952347205
  Care Compare affiliation

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1245986140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226102",
            "telephone_number": "646-413-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5645 Main St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113555045",
            "country_code": "US",
            "telephone_number": "718-670-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROH",
        "first_name": "KYUNGMOON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-01",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ01262000",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "680524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janene E. Rodriguez, M.S., CCC-SLP
• Karolina Anna Rodriguez, DDS
• Leonela Rodriguez, LMT
• Saul Rodriguez, DPM
• Benno George Roesch, MD
• Alla Roitman, DO
• Rachel Elizabeth Rolnick, DDS
• Alissa Roman, DDS
• Donald Joseph Roman, DMD
• Jocelyn Roman, MD

• Certified Registered Nurse Anesthetist in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.