Individual provider Active NPI

Jessica Mary Cortezzo, CRNA

  • Certified Registered Nurse Anesthetist
  • Reston, VA
National Provider Identifier
1649586934
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024169038 Issued in VA
Practice address
1850 Town Center Pkwy
Reston, VA 20190-3219
Phone
(703) 689-9000
NPI assigned
Aug 24, 2010
Last updated
Nov 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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 0024169038 VA Primary

Addresses

Primary practice location

1850 Town Center Pkwy
Reston, VA 20190-3219

Mailing address

1122 Basil Rd
MC Lean, VA 22101-1802
Phone (310) 922-7097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000998 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597947846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reston Anesthesia Associates PCGroup PAC ID 2567361124, 52 clinicians

Practice addresses (Care Compare)

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 689-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Anesthesia Associates, PC CurrentSince Jan 15, 2011 Accepting new patients

Locations

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1649586934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 BASIL RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221011802",
            "telephone_number": "310-922-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903219",
            "telephone_number": "703-689-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZZO",
        "first_name": "JESSICA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.