Individual provider Active NPI

Jennifer L Nevala, CRNA

  • Certified Registered Nurse Anesthetist
  • Olney, MD
National Provider Identifier
1295850634
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R144190 Issued in MD
Practice address
18101 Prince Philip Dr
Olney, MD 20832-1514
Phone
(301) 598-5100
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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 R144190 MD Primary

Addresses

Primary practice location

18101 Prince Philip Dr
Olney, MD 20832-1514

Mailing address

PO Box 79977
Baltimore, MD 21279-0977

Other identifiers 1

IdentifierTypeStateIssuer
405293500MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000648 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385619709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

18101 Prince Philip Dr
Olney, MD 20832-1514
Phone (301) 570-7404

18105 Prince Philip Dr
Olney, MD 20832-1514
Phone (301) 774-8962

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

Hospital & facility affiliations

  • Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince May 1, 2018 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince May 1, 2018 Accepting new patients
Meridian Anesthesia Practice, L.L.C Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1295850634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79977",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321514",
            "telephone_number": "301-598-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVALA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R144190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405293500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.