Individual provider Active NPI

Pamela Wiest, CRNA

  • Certified Registered Nurse Anesthetist
  • Englewood, NJ
National Provider Identifier
1407880826
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NR09770800 Issued in NJ
Practice address
350 Engle St
Englewood, NJ 07631-1808
Phone
(201) 894-3238
Fax
(201) 871-0619
NPI assigned
Jul 10, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 26NR09770800 NJ Primary

Addresses

Primary practice location

350 Engle St
Englewood, NJ 07631-1808

Mailing address

375 Engle St
Second Floor
Englewood, NJ 07631-1823
Phone (201) 871-6073

Other identifiers 1

IdentifierTypeStateIssuer
430076989OtherNJRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000381 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254504228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Valley Anesthesiology PAGroup PAC ID 0749194868, 85 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 871-6073

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR09770800NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Valley Anesthesiology, P.a. CurrentSince May 6, 2002 Accepting new patients
Dansville Anesthesia & Pain Treatment, PLLC Past Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

375 Engle St
#2
Englewood, NJ 07631
Phone (201) 871-0684

75 Froehlich Farm Blvd
Woodbury, NY 11797
Phone (516) 496-2122

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 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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1407880826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ENGLE ST",
            "address_2": "SECOND FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311823",
            "telephone_number": "201-871-6073",
            "fax_number": "201-655-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-894-3238",
            "fax_number": "201-871-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "PAMELA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR09770800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430076989",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.