Individual provider Active NPI

Sandra M Acevedo, CRNA

  • Certified Registered Nurse Anesthetist
  • Newburgh, NY
National Provider Identifier
1609971597
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
415377-1 Issued in NY
Practice address
70 Dubois St
St. Lukes Hospital
Newburgh, NY 12550-4851
Phone
(845) 561-4400
Fax
(845) 790-2675
NPI assigned
Sep 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 415377-1 NY Primary

Addresses

Primary practice location

70 Dubois St
St. Lukes Hospital
Newburgh, NY 12550-4851

Mailing address

2 Catharine St
P O Box 550
Poughkeepsie, NY 12601-3100
Phone (866) 885-2318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111122000180 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587838909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
415377-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Feb 8, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Feb 8, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609971597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CATHARINE ST",
            "address_2": "P O BOX 550",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013100",
            "telephone_number": "866-885-2318",
            "fax_number": "845-790-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DUBOIS ST",
            "address_2": "ST. LUKES HOSPITAL",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125504851",
            "telephone_number": "845-561-4400",
            "fax_number": "845-790-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "415377-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

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