Individual provider Active NPI

Stephanie Nicole Woltering, CRNA

  • Certified Registered Nurse Anesthetist
  • Miller Place, NY
National Provider Identifier
1427617539
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7380 Issued in NC
Practice address
92 Sylvan Ave
Miller Place, NY 11764-2229
Phone
(631) 872-4178
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 720002 NY
Certified Registered Nurse Anesthetist 367500000X APN.0998673CRNA CO
Certified Registered Nurse Anesthetist 367500000X APRN11028526 FL
Certified Registered Nurse Anesthetist 367500000X 7380 NC Primary

Addresses

Primary practice location

92 Sylvan Ave
Miller Place, NY 11764-2229

Mailing address

92 Sylvan Ave
Miller Place, NY 11764-2229
Phone (631) 872-4178

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312000854 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769878941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 873-9533

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7380NCMDDentist
720002NYMDRegistered Nurse
APN.0998673CRNACOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients

Locations

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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 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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1427617539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 SYLVAN AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642229",
            "telephone_number": "631-872-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 SYLVAN AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642229",
            "telephone_number": "631-872-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERING",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "720002",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.0998673CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11028526",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "7380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.