Individual provider Active NPI

Michael Konstantinovsky

  • Certified Registered Nurse Anesthetist
  • New Brunswick, NJ
National Provider Identifier
1447909304
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ01331800 Issued in NJ
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 828-3000
NPI assigned
Mar 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 686170 NY
Certified Registered Nurse Anesthetist 367500000X 26NJ01331800 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

115 Erika Loop
Staten Island, NY 10312-6660
Phone (917) 575-7815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221110001032 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032586664 Reassigns benefits to 1 organization
I20230622000550 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032586664 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rutgers New Jersey Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians

Practice addresses (Care Compare)

99 Hwy 37 W
Toms River, NJ 08755-6423
Phone (732) 557-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01331800NJMDCertified Registered Nurse Anesthetist
686170NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Jun 20, 2024 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Mar 10, 2023 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Mar 10, 2023 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Jul 11, 2022 Accepting new patients
Parkway Anesthesia Associates LLC CurrentSince Aug 8, 2023 Accepting new patients

Locations

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1 Robert Wood Johnson Pl
#G
New Brunswick, NJ 08901
Phone (732) 937-8841

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

865 Stone St
Rahway, NJ 07065
Phone (732) 381-4000

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Organizations & group practices 6

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 4

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": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1447909304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ERIKA LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126660",
            "telephone_number": "917-575-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-828-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONSTANTINOVSKY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-19",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "686170",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ01331800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

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

Verify at the official NPI Registry.