Active NPI
Katie Sullivan Jensen, CRNA
- Certified Registered Nurse Anesthetist
- Harrisburg, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN592667
- Practice address
- 111 S Front St
Harrisburg, PA 17101-2010 - Phone
- (717) 782-5118
- Fax
- (717) 782-5854
- NPI assigned
- May 24, 2011
- Last updated
- Jan 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R162842 | MD | |
| Certified Registered Nurse Anesthetist | 367500000X | RN592667 | PA | Primary |
| Registered Nurse | 163W00000X | RN592667 | PA | |
| Registered Nurse | 163W00000X | 174761-30 | WI |
Addresses
Primary practice location
111 S Front St
Harrisburg, PA 17101-2010
Mailing address
409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612
Phone (717) 782-3282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102912432 | Medicaid | PA |
Other names 1
- Miss Katie Gayle Sullivan
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kjensen18982@phsdirect.pinnaclehealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3282
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174761-30 | WI | MD | Registered Nurse |
| RN592667 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia, Pennsylvania , LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Upmc Pinnacle Anesthesia Services, LLC | Current | Accepting new patients | |
| Upmc Pinnacle Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951
111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282
409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049
4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044
8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227
Interoperability endpoints
- kjensen18982@phsdirect.pinnaclehealth.org
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Harrisburg, PA
- NPI 1730693979
-
- Anesthesiology Physician
- Melville, NY
- NPI 1639137854
Nurse Anesthetist, Certified Registered, PA
-
dba UPMC Pinnacle Anesthesia Services CRNA
- Certified Registered Nurse Anesthetist
- Harrisburg, PA
- NPI 1942867064
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Harrisburg, PA
- NPI 1265537674
-
- General Acute Care Hospital
- Harrisburg, PA
- NPI 1407813603
-
dba UPMC Pinnacle West Shore
- General Acute Care Hospital
- Mechanicsburg, PA
- NPI 1972613305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1629361639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 S 2ND ST",
"address_2": "SUITE 2F",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171041612",
"telephone_number": "717-782-3282",
"fax_number": "717-231-8964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "717-782-5118",
"fax_number": "717-782-5854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "KATIE",
"middle_name": "SULLIVAN",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MD",
"license": "R162842",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN592667",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN592667",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "174761-30",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102912432",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kjensen18982@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "111 S Front St",
"city": "Harrisburg",
"state": "PA",
"country_code": "US",
"postal_code": "171012010",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATIE",
"last_name": "SULLIVAN",
"middle_name": "GAYLE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.