Individual provider Active NPI

Jay Biesenthal, CRNA

  • Certified Registered Nurse Anesthetist
  • South Bend, IN
National Provider Identifier
1669471827
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28230243A Issued in IN
Practice address
211 N Eddy St
South Bend, IN 46617-2808
Phone
(574) 234-8161
NPI assigned
Jul 20, 2005
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 127107 NC
Certified Registered Nurse Anesthetist 367500000X 28230243A IN Primary

Addresses

Primary practice location

211 N Eddy St
South Bend, IN 46617-2808

Mailing address

401 Charleston Dr
Clayton, NC 27527-3950
Phone (919) 553-4527

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 609-6440 ext. 6440

Other identifiers 2

IdentifierTypeStateIssuer
201384080MedicaidIN
8052067MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070806000501 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113989823 Reassigns benefits to 1 organization
I20160826000227 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113989823 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Australia Anesthesia Management LLCGroup PAC ID 9436671864, 58 clinicians
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Jebs Anesthesia Consultants, LLCGroup PAC ID 4486046646, 37 clinicians
United Surgeons LLCGroup PAC ID 0941260061, 22 clinicians
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-1000

2001 Stults Rd
Huntington, IN 46750-1291
Phone (260) 355-3000

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 299-2450

4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1414
Phone (574) 231-6800

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
127107NCMDInternal Medicine Physician
28230243AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
The South Bend Clinic LLC CurrentSince Apr 26, 2022 Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 31, 2025 Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 31, 2025 Accepting new patients
Ams Northern Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 17, 2022 Accepting new patients
The South Bend Clinic, LLC CurrentSince Apr 26, 2022 Accepting new patients
United Surgeons, LLC Current Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Stat Anesthesia Specialists LTD CurrentSince Jun 10, 2023 Accepting new patients
Australia Anesthesia Management LLC CurrentSince Jan 16, 2025 Accepting new patients
Great Lakes Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2016 Accepting new patients
Jebs Anesthesia Consultants, LLC CurrentSince Jan 1, 2022 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2018 Accepting new patients
Stat Anesthesia Specialists, LTD. CurrentSince Jun 10, 2023 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients
Mymichigan Medical Center Tawas Past Accepting new patients

Locations (25 of 34)

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

18221 Torrence Ave
Ste 1B
Lansing, IL 60438
Phone (708) 474-7600

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

11460 Broadway
Crown Point, IN 46307
Phone (219) 488-0155

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

1004 Parkway Ave
Ste A
Elkhart, IN 46516
Phone (800) 966-7841

2310 California Rd
Elkhart, IN 46514
Phone (574) 264-0791

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

7747 W Jefferson Blvd
#A
Fort Wayne, IN 46804
Phone (260) 459-8400

1605 Winsted Dr
Goshen, IN 46526
Phone (574) 364-2970

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

533 E County Line Rd
Ste 201
Greenwood, IN 46143

6836 Hohman Ave
Hammond, IN 46324
Phone (219) 931-7509

2001 Stults Rd
Huntington, IN 46750
Phone (219) 355-3000

900 I St
Laporte, IN 46350
Phone (219) 324-1670

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

8514 Broadway
Merrillville, IN 46410
Phone (219) 756-5010

8900 Broadway
Merrillville, IN 46410
Phone (219) 252-2173

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

3930 Edison Lakes Pkwy
Ste 100
Mishawaka, IN 46545

4455 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 231-6134

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 4

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1669471827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CHARLESTON DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275273950",
            "telephone_number": "919-553-4527",
            "fax_number": "919-553-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-234-8161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-609-6440 x6440",
            "fax_number": "910-609-5365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIESENTHAL",
        "first_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "127107",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28230243A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201384080",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052067",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.