Individual provider Active NPI

Joseph Johannan Pannapara

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1679984884
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN563132 Issued in PA
Practice address
111 S 11TH St # 8490
Philadelphia, PA 19107-4824
Phone
(215) 955-6161
Fax
(215) 923-5507
NPI assigned
May 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NR14443900 NJ
Certified Registered Nurse Anesthetist 367500000X L1-0039648 DE
Certified Registered Nurse Anesthetist 367500000X RN563132 PA Primary

Addresses

Primary practice location

111 S 11TH St # 8490
Philadelphia, PA 19107-4824

Mailing address

901 N Penn St Unit P1805
Philadelphia, PA 19123-3142
Phone (215) 300-7393

Other names 1

  • Mr. Pannapara Joseph Johannan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140902000609 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668690884 Reassigns benefits to 2 organizations
I20150319001740 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668690884 Reassigns benefits to 3 organizations
I20201124002363 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668690884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Drexel University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
North American Partners in Anesthesia, Pennsylvania , LLCGroup PAC ID 7517960834, 302 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

8835 Germantown Ave
Phila, PA 19118-2718
Phone (215) 248-8227

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0039648DEMDCertified Registered Nurse Anesthetist
26NR14443900NJMDCertified Registered Nurse Anesthetist
RN563132PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Delaware, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2020 Accepting new patients
Anesthesia Services PA CurrentSince Jul 3, 2014 Accepting new patients
Deaconess Hospital Inc CurrentSince Dec 21, 2020 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 24, 2020 Accepting new patients
Deaconess Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 21, 2020 Accepting new patients
Deaconess Hospital, Inc Current Accepting new patients
Jefferson University Physicians CurrentSince Mar 1, 2015 Accepting new patients
Associates in Anesthesia, Inc. CurrentSince Aug 4, 2022 Accepting new patients
Associates in Anesthesia Past Accepting new patients

Locations

2600 Glasgow Ave
Ste 226
Newark, DE 19702
Phone (302) 836-3539

701 N Clayton St
Wilmington, DE 19805
Phone (302) 421-4100

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147

30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
#8490
Philadelphia, PA 19107
Phone (215) 955-6161

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 9

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1679984884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N PENN ST UNIT P1805",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233142",
            "telephone_number": "215-300-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST # 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNAPARA",
        "first_name": "JOSEPH",
        "middle_name": "JOHANNAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR14443900",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L1-0039648",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN563132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PANNAPARA",
            "last_name": "JOHANNAN",
            "middle_name": "JOSEPH",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.