Active NPI
Jordan Ross Waldman, CRNA
- Certified Registered Nurse Anesthetist
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 696827
- Practice address
- 121 Dekalb Ave
Brooklyn, NY 11201-5493 - Phone
- (718) 250-8000
- NPI assigned
- Jul 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 696827-01 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 696827 | NY | Primary |
Addresses
Primary practice location
121 Dekalb Ave
Brooklyn, NY 11201-5493
Mailing address
3100 Denton Dr
Merrick, NY 11566-5115
Phone (516) 244-5824
Other practice location 1
560 W 169th St
New York, NY 10032-3913
Phone (212) 305-4318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 696827-01 | NY | MD | Critical Care Medicine Registered Nurse |
| 696827 | NY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia LLP | Current | Accepting new patients |
Locations
7 Southwoods Blvd
Ste 4
Albany, NY 12211
121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604
3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Melville, NY
- NPI 1649264706
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1326046467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1417566076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 DENTON DR",
"city": "MERRICK",
"state": "NY",
"postal_code": "115665115",
"telephone_number": "516-244-5824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015493",
"telephone_number": "718-250-8000"
}
],
"practiceLocations": [
{
"address_1": "560 W 169th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100323913",
"country_code": "US",
"telephone_number": "212-305-4318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALDMAN",
"first_name": "JORDAN",
"middle_name": "ROSS",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-29",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NY",
"license": "696827-01",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "696827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.