Individual provider Active NPI

Berniece A Ajavon, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, DE
National Provider Identifier
1609803493
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
L6-0A00446 Issued in DE
Practice address
4755 Ogletown Stanton Road
Newark, DE 19718-1320
Phone
(302) 733-1000
Fax
(302) 733-2685
NPI assigned
Jun 27, 2006
Last updated
Apr 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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 L6-0A00446 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Road
Newark, DE 19718-1320

Mailing address

2 Reads Way
Suite 201
New Castle, DE 19720-1630
Phone (302) 709-4709

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050221000185 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850343609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rutgers New Jersey Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services PAGroup PAC ID 9537064498, 201 clinicians

Practice addresses (Care Compare)

2600 Glasgow Ave
Suite 226
Newark, DE 19702-5709
Phone (302) 836-3539

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

501 W 14TH St
Wilmington, DE 19801-1013
Phone (302) 477-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L6-0A00446DEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services PA CurrentSince Jan 4, 2005 Accepting new patients

Locations

2 Reads Way
Ste 201
New Castle, DE 19720
Phone (302) 709-4504

2600 Glasgow Ave
Ste 226
Newark, DE 19702
Phone (302) 836-3539

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1609803493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 READS WAY",
            "address_2": "SUITE 201",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201630",
            "telephone_number": "302-709-4709",
            "fax_number": "302-709-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197181320",
            "telephone_number": "302-733-1000",
            "fax_number": "302-733-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAVON",
        "first_name": "BERNIECE",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L6-0A00446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.