NPIMap

Individual provider Active NPI

Bernice C Jacobs, CRNA

  • Certified Registered Nurse Anesthetist
  • Lorain, OH
National Provider Identifier
1437142916
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA01928 Issued in OH
Practice address
6125 S Broadway
Lorain, OH 44053-3820
Phone
(440) 233-8181
Fax
(440) 233-8182
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA01928 OH Primary
Registered Nurse 163W00000X RN185635 OH

Addresses

Primary practice location

6125 S Broadway
Lorain, OH 44053-3820

Mailing address

PO Box 901681
Cleveland, OH 44190-1681
Phone (440) 233-8181

Other identifiers 1

IdentifierTypeStateIssuer
2029996MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080507000648 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850470451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (440) 226-2596

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN185635OHMDRegistered Nurse
NA01928OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Lima Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Consultants in Anesthesiology, Inc Past Accepting new patients
Northcoast Anesthesia Providers Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Anesthesia Associates of Northern Ohio, Inc. PastSince Jan 1, 1996 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 7

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 6

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1437142916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901681",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441901681",
            "telephone_number": "440-233-8181",
            "fax_number": "440-233-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533820",
            "telephone_number": "440-233-8181",
            "fax_number": "440-233-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BERNICE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA01928",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN185635",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029996",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.