Individual provider Active NPI

Jennifer Enteshary, CRNA

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
National Provider Identifier
1629478151
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
92730 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 715-3610
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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 92730 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

3650 W Rock Creek Rd Ste 100
Norman, OK 73072-2202
Phone (405) 701-3418

Other practice location 1

3650 W Rock Creek Rd Ste 100
Norman, OK 73072-2202
Phone (405) 701-3418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141031000536 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587885702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Anesthesia Providers, P.C.Group PAC ID 4385536333, 35 clinicians

Practice addresses (Care Compare)

3300 Healthplex Pkwy
Norman, OK 73072-9749
Phone (405) 515-1000

3400 W Tecumseh Rd
Suite 301
Norman, OK 73072-1812
Phone (405) 801-4200

901 N Porter Ave
Norman, OK 73071-6404
Phone (405) 307-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92730OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Anesthesia Providers, P.C. CurrentSince Feb 1, 2016 Accepting new patients

Locations

3121 S Telephone Rd
Moore, OK 73160
Phone (405) 321-0370

3650 W Rock Creek Rd
#100
Norman, OK 73072
Phone (405) 701-3418

3400 W Tecumseh Rd
Ste 301
Norman, OK 73072
Phone (405) 364-6764

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

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 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": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1629478151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 W ROCK CREEK RD STE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722202",
            "telephone_number": "405-701-3418",
            "fax_number": "405-701-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-715-3610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 W Rock Creek Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730722202",
            "country_code": "US",
            "telephone_number": "405-701-3418",
            "fax_number": "405-701-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENTESHARY",
        "first_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "92730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.