Individual provider Active NPI

Ahmadu Tejani Jalloh, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Hackensack, NJ
National Provider Identifier
1265118467
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ14865600 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
Jun 23, 2023
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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 26NJ14865600 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

140 Mayhill St Apt 413
Saddle Brook, NJ 07663-4671
Phone (845) 521-4203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231212001956 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486003753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

355 Grand St
Jersey City, NJ 07302-4321
Phone (201) 915-2000

65 James St
Edison, NJ 08820-3947
Phone (201) 854-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ14865600NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC CurrentSince Nov 1, 2023 Accepting new patients
Parkway Anesthesia Associates LLC CurrentSince Oct 13, 2025 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

65 James St
Edison, NJ 08820
Phone (732) 321-7010

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

Organizations & group practices 2

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 4

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1265118467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MAYHILL ST APT 413",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076634671",
            "telephone_number": "845-521-4203"
        },
        {
            "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": "551-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOH",
        "first_name": "AHMADU",
        "middle_name": "TEJANI",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ14865600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.