Individual provider Active NPI

Jeffrey John Podlaskowich, DNAP, CRNA

  • Certified Registered Nurse Anesthetist
  • Hackensack, NJ
National Provider Identifier
1568211399
Registry record updated Mar 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ15149800 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
Fax
(201) 487-0944
NPI assigned
May 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2025

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 26NJ15149800 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

11 Cornwallis Rd
Toms River, NJ 08755-1702
Phone (848) 210-7347

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003001787 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719418573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 488-0066

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital Nurse Anesthetist, Certified Registered CurrentSince May 25, 2025 Accepting new patients
University Hospital CurrentSince May 25, 2025 Accepting new patients
New Jersey Healthcare Specialists PC CurrentSince Sep 16, 2024 Accepting new patients
Rwjbh Observation Associates LLC CurrentSince Nov 21, 2024 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

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

150 Bergen St
#E245
Newark, NJ 07103
Phone (973) 972-7867

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

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

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 2

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": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1568211399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CORNWALLIS RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551702",
            "telephone_number": "848-210-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000",
            "fax_number": "201-487-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLASKOWICH",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "credential": "DNAP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15149800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; 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.