Individual provider Active NPI

Jennifer Rebecca Georgievski, CRNA

  • Certified Registered Nurse Anesthetist
  • Port Huron, MI
National Provider Identifier
1598053183
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704225745 Issued in MI
Practice address
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone
(810) 987-5000
NPI assigned
Jul 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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 4704225745 MI Primary

Addresses

Primary practice location

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Mailing address

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Other names 1

  • Jennifer Rebecca Isrow Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111105000053 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466625538 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Michigan State University College of Human Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2023 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
Henry Ford Health River District Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 24, 2012 Accepting new patients
Henry Ford Health System CurrentSince Aug 18, 2023 Accepting new patients
Henry Ford Health Rochester Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Henry Ford Health Rochester Hospital CurrentSince Aug 1, 2022 Accepting new patients
Henry Ford Health River District Hospital CurrentSince Jul 24, 2012 Accepting new patients
McLaren Port Huron Past Accepting new patients

Locations

7560 Solutions Ctr
Chicago, IL 60677

7967 Solutions Ctr Dr
Chicago, IL 60677

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

21510 Harrington St
Ste 300
Clinton Twp, MI 48036
Phone (586) 323-4560

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
  • Direct secure messaging: jgeorgievski893316@direct.hfhs.org

Organizations & group practices 8

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": "1310774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1598053183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIEVSKI",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-16",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704225745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ISROW",
            "middle_name": "REBECCA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.