Individual provider Active NPI

Jill L. Hanisak, CRNA

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
National Provider Identifier
1508853375
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
046891 Issued in PA
Practice address
1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone
(610) 402-9080
Fax
(610) 402-9029
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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 RN240246L PA
Certified Registered Nurse Anesthetist 367500000X 046891 PA Primary

Addresses

Primary practice location

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

Mailing address

1245 S Cedar Crest Blvd
Suite #301
Allentown, PA 18103-6258
Phone (610) 402-9080

Other identifiers 10

IdentifierTypeStateIssuer
1546038OtherPAGATEWAY
0017673800006MedicaidPA
03224201OtherPACAPITAL ADVANTAGE
1343791OtherPAHIGHMARK
1343791OtherPAKHP CENTRAL
11776573OtherPACAQH
1343791OtherPAFIRST PRIORITY
2036405000OtherPAINDEP. BLUE CROSS
82851OtherPAGEISINGER
9573465OtherPAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000151 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406740901 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

330 Main St
Dickson City, PA 18519-1691
Phone (610) 402-6164

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046891PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2024 Accepting new patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2002 Accepting new patients
Professional Anesthesia Services of North America P.C. Nurse Anesthetist, Certified Registered CurrentSince Feb 9, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2024 Accepting new patients
Anesthesia Specialists of Bethlehem, PC Nurse Anesthetist, Certified Registered PastSince Oct 21, 2025 Accepting new patients

Locations

1245 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 402-9080

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

330 Main St
Scranton, PA 18519
Phone (570) 330-5000

100 E Lancaster Ave
Ste 158
Wynnewood, PA 19096
Phone (484) 206-5800

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 5

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1508853375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD",
            "address_2": "SUITE #301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-9080",
            "fax_number": "610-402-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202",
            "telephone_number": "610-402-9080",
            "fax_number": "610-402-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANISAK",
        "first_name": "JILL",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN240246L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "046891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1546038",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017673800006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "03224201",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1343791",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP CENTRAL",
            "identifier": "1343791",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11776573",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "1343791",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEP. BLUE CROSS",
            "identifier": "2036405000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "82851",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9573465",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.