Individual provider Active NPI

Patrickpaul T Waga, CRNA

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1548577208
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
598478 Issued in NY
Practice address
345 E 94TH St Apt 21G
New York, NY 10128-5696
Phone
(732) 692-3990
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 598478 NY Primary

Addresses

Primary practice location

345 E 94TH St Apt 21G
New York, NY 10128-5696

Mailing address

345 E 94TH St Apt 21G
New York, NY 10128-5696
Phone (732) 692-3990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151009002256 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789854092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists of Warren, LLCGroup PAC ID 5294006250, 33 clinicians

Practice addresses (Care Compare)

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 847-6700

Hospital & facility affiliations

  • St Luke'S Warren Hospital Hospital, Phillipsburg, NJ, CCN 310060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Warren Physician Group, PC CurrentSince Apr 1, 2020 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Apr 1, 2020 Accepting new patients
St. Luke'S Warren Physician Group, PC Current Accepting new patients
Anesthesia Specialists of Warren, LLC CurrentSince Jul 24, 2019 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

Organizations & group practices 4

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1548577208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E 94TH ST APT 21G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285696",
            "telephone_number": "732-692-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 94TH ST APT 21G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285696",
            "telephone_number": "732-692-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGA",
        "first_name": "PATRICKPAUL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "598478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.