Individual provider Active NPI

Jennifer Vaccaro Conrad, CRNA

  • Certified Registered Nurse Anesthetist
  • Pittsburgh, PA
National Provider Identifier
1265072433
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
111907 Issued in WV
Practice address
3500 Victoria Street School of Anesthesia
Pittsburgh, PA 15261-0001
Phone
(412) 624-4586
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 94111 WV
Critical Care Medicine Registered Nurse 163WC0200X RN714741 PA
Certified Registered Nurse Anesthetist 367500000X 111907 WV Primary

Addresses

Primary practice location

3500 Victoria Street School of Anesthesia
Pittsburgh, PA 15261-0001

Mailing address

488 Wisconsin Ave
Morgantown, WV 26501-3938
Phone (716) 499-6229

Other names 1

  • Jennifer Lyne Vaccaro Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JLV51@pitt.edu Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220411001241 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880080308 Reassigns benefits to 1 organization
I20260306003582 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880080308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Pittsburgh School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

Hospital & facility affiliations

  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN714741PAMDCritical Care Medicine Registered Nurse
94111WVMDCritical Care Medicine Registered Nurse
111907WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Current Accepting new patients
West Virginia University Medical Corporation CurrentSince Feb 28, 2022 Accepting new patients
Wvu Med Corp Cheat Lake Physicians CurrentSince Feb 28, 2022 Accepting new patients
Fayette Physician Network Inc CurrentSince Feb 17, 2026 Accepting new patients
Fayette Physician Network Inc CurrentSince Feb 17, 2026 Accepting new patients

Locations

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

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.

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1265072433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 WISCONSIN AVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013938",
            "telephone_number": "716-499-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 VICTORIA STREET SCHOOL OF ANESTHESIA",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152610001",
            "telephone_number": "412-624-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JENNIFER",
        "middle_name": "VACCARO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WV",
            "license": "94111",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN714741",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "111907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JLV51@pitt.edu",
            "affiliation": "N",
            "endpointDescription": "University Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3500 Victoria Street School Of Anesthesia",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152610001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VACCARO",
            "middle_name": "LYNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.