Individual provider Active NPI

Jessica Marie Laslovich

  • Certified Registered Nurse Anesthetist
  • Goshen, IN
National Provider Identifier
1508515396
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
281848927 Issued in IN
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(317) 340-8384
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28248221A IN
Certified Registered Nurse Anesthetist 367500000X 281848927 IN Primary

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

11217 Candice Dr
Fishers, IN 46038-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523003128 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577942200 Reassigns benefits to 5 organizations

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)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281848927INMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jun 13, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jun 13, 2023 Accepting new patients
Amsurg Clovis Ca Anesthesia LP Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
La Jolla Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince Aug 11, 2024 Accepting new patients
Amsurg South Bay Anesthesia LP CurrentSince Aug 11, 2024 Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

501 N Medical Center Dr E
Ste 101
Clovis, CA 93611
Phone (559) 797-9290

9850 Genesee Ave
Ste 980
La Jolla, CA 92037
Phone (858) 453-7525

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

23560 Madison St
Torrance, CA 90505
Phone (310) 325-6331

Organizations & group practices 9

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1508515396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 CANDICE DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460385555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "317-340-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLOVICH",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28248221A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "281848927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.