Active NPI
Jenny Shmushkevich, CRNA
- Certified Registered Nurse Anesthetist
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 26NJ00422600
- Practice address
- 355 Bard Ave
Staten Island, NY 10310-1699 - Phone
- (718) 818-1234
- NPI assigned
- Nov 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 26NR14071400 | NJ | |
| Registered Nurse | 163W00000X | 581083 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 26NJ00422600 | NJ | Primary |
Addresses
Primary practice location
355 Bard Ave
Staten Island, NY 10310-1699
Mailing address
100 Route 59
Suite 105
Suffern, NY 10901-4927
Phone (845) 357-5775
Other practice location 1
1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6991
Other practice location 2
1305 Walt Whitman Rd Ste 300
Melville, NY 11747-4300
Phone (516) 945-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000
703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 581083 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Marys General Medical Group PC | Current | Accepting new patients | |
| Prime Healthcare Services - St. Mary's Passaic LLC | Current | Accepting new patients | |
| Prime Healthcare Services - St. Mary's Passaic, LLC | Current | Accepting new patients | |
| North American Partners in Anesthesia LLP | Current | Accepting new patients | |
| Parkway Anesthesia Associates LLC | Current | Accepting new patients | |
| North American Partners in Anesthesia of New Jersey LLC | Current | Accepting new patients |
Locations
1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008
495 Jack Martin Blvd
Ste 1
Brick, NJ 08724
Phone (732) 836-9800
41 Arthur St
East Brunswick, NJ 08816
Phone (718) 948-8880
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
360 Route 70
Lakewood, NJ 08701
Phone (732) 367-3050
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200
1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100
111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060
350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
865 Stone St
Rahway, NJ 07065
Phone (732) 381-4000
99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232
99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000
7 Southwoods Blvd
Ste 4
Albany, NY 12211
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
355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380
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.
-
- Anesthesiology Physician
- Brick, NJ
- NPI 1548433048
-
- Anesthesiology Physician
- North Bergen, NJ
- NPI 1518319755
-
dba St. Mary's Hospital
- General Acute Care Hospital
- Passaic, NJ
- NPI 1730508250
-
- Internal Medicine Physician
- Passaic, NJ
- NPI 1477261741
-
- Anesthesiology Physician
- Melville, NY
- NPI 1649264706
-
dba St. Mary's Hospital
- General Acute Care Hospital
- Passaic, NJ
- NPI 1770901761
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Toms River, NJ
- NPI 1013010917
-
- General Acute Care Hospital
- New Brunswick, NJ
- NPI 1114924834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1467797753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 ROUTE 59",
"address_2": "SUITE 105",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109014927",
"telephone_number": "845-357-5775",
"fax_number": "845-357-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101699",
"telephone_number": "718-818-1234"
}
],
"practiceLocations": [
{
"address_1": "1 Bay Ave",
"address_purpose": "LOCATION",
"city": "Montclair",
"state": "NJ",
"postal_code": "070424837",
"country_code": "US",
"telephone_number": "973-429-6991",
"fax_number": "845-357-5777",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1305 Walt Whitman Rd Ste 300",
"address_purpose": "LOCATION",
"city": "Melville",
"state": "NY",
"postal_code": "117474300",
"country_code": "US",
"telephone_number": "516-945-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHMUSHKEVICH",
"first_name": "JENNY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-28",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NJ",
"license": "26NR14071400",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "581083",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NJ",
"license": "26NJ00422600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.