Individual provider Active NPI

Kate W Spina, CRNA

  • Certified Registered Nurse Anesthetist
  • Englewood, NJ
National Provider Identifier
1417030784
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NO11755500 Issued in NJ
Practice address
350 Engle St
Englewood, NJ 07631-1808
Phone
(201) 871-6073
Fax
(201) 655-6159
NPI assigned
Oct 23, 2006
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 26NO11755500 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
P00402023OtherNJRAILROAD MEDICARE

Other names 1

  • Kate W Myersburg Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000251 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173525060 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maywood Anesthesia Consultants LLCGroup PAC ID 7618100223, 4 clinicians
Bay AnesthesiaGroup PAC ID 0446639306, 75 clinicians

Practice addresses (Care Compare)

113 W Essex St
Suite 201
Maywood, NJ 07607-1023
Phone (973) 886-3933

561 Cranbury Rd
East Brunswick, NJ 08816-5400
Phone (201) 620-3010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maywood Anesthesia Consultants LLC CurrentSince Jan 12, 2014 Accepting new patients
Northern Valley Anesthesiology, P.a. CurrentSince Oct 19, 2006 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

113 W Essex St
Ste 201
Maywood, NJ 07607
Phone (201) 226-0145

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1417030784",
    "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": "201-871-6073",
            "fax_number": "201-655-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINA",
        "first_name": "KATE",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NO11755500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00402023",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "MYERSBURG",
            "middle_name": "W",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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.