Jarrod Prebola, CRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

69004 Issued in NM

Practice address

553 Hillside View Dr
Duncansville, PA 16635-7459

Phone

(814) 207-3903

NPI assigned

Sep 7, 2022

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
• Lovelace Women's Hospital Hospital, Albuquerque, NM, CCN 320017
• Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Street Anesthesia of New Mexico, LLC

  • Anesthesiology Physician
  • Albuquerque, NM
  • NPI 1275010985
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Westside Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1649373887
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Women's Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1982799375
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1639890775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 ACADEMY RD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093363",
            "telephone_number": "814-207-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 HILLSIDE VIEW DR",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166357459",
            "telephone_number": "814-207-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBOLA",
        "first_name": "JARROD",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "69004",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "69004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Renee Phillips-Dinant, COTA/L, CLT
• Linda D Pleshko
• Delaney Jolene Ponist, LPN
• Dana M Postreich
• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Ashley Price, LPN
• Private Care Resources, Inc (Private Care Home Nursing Agency)
• Mary M Prorok
• Tonya Jean Pruey, LPN
• Pyramid Health Care Inc.

• Registered Nurse in Duncansville, PA
• Providers in Duncansville, PA by specialty
• Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.