Individual provider Active NPI

Julie Prusakowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1588683080
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
501992 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(215) 829-5556
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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 501992 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000088 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830362748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Society Hill Anesthesia Consultants PCGroup PAC ID 5991617292, 210 clinicians

Practice addresses (Care Compare)

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-5664

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
501992PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants, PC CurrentSince Feb 4, 2002 Accepting new patients
Philadelphia Health & Education Corporation Past Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1588683080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSAKOWSKI",
        "first_name": "JULIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "501992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.