Individual provider Active NPI

Dominique Adriana Jarjuri

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1649751256
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00862600 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(800) 826-6737
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 122090 PA
Certified Registered Nurse Anesthetist 367500000X 26NJ00862600 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191211001144 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002169893 Reassigns benefits to 3 organizations
I20230309002731 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002169893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Cares - CommunityGroup PAC ID 9537526330, 187 clinicians

Practice addresses (Care Compare)

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Hospital & facility affiliations

  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00862600NJMDCertified Registered Nurse Anesthetist
122090PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jan 9, 2023 Accepting new patients
Dominion Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2019 Accepting new patients
Inova Cares - Community CurrentSince Nov 1, 2023 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

1701 N George Mason Dr
Ste 2D
Arlington, VA 22205
Phone (703) 558-2438

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

3620 Joseph Siewick Dr
Ste 202
Fairfax, VA 22033
Phone (703) 766-6960

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

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 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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1649751256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "800-826-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARJURI",
        "first_name": "DOMINIQUE",
        "middle_name": "ADRIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "122090",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00862600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.