Individual provider Active NPI

Robert Mirynowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Freehold, NJ
National Provider Identifier
1689685232
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00183300 Issued in NJ
Practice address
901 W Main St BLDG B
Freehold, NJ 07728-2537
Phone
(732) 303-1616
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26N007829700 NJ
Certified Registered Nurse Anesthetist 367500000X 26NJ00183300 NJ Primary

Addresses

Primary practice location

901 W Main St BLDG B
Freehold, NJ 07728-2537

Mailing address

882 Elton Adelphia Rd
Freehold, NJ 07728-8616
Phone (732) 740-2357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000567 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991808305 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26N007829700NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Shrewsbury Ambulatory Anesthesia LLC CurrentSince Jan 31, 2018 Accepting new patients
Toms River Ambulatory Anesthesia LLC CurrentSince Jan 5, 2019 Accepting new patients
Toms River Ambulatory Anesthesia LLC CurrentSince Jan 5, 2019 Accepting new patients
Allied Digestive Health, LLC PastSince Jan 1, 2015 Accepting new patients
Associated Pain Specialists, LLC Past Accepting new patients

Locations

3613 State Route 33
Neptune, NJ 07753
Phone (732) 275-7779

655 Shrewsbury Ave
Shrewsbury, NJ 07702
Phone (732) 450-6000

1430 Hooper Ave
Toms River, NJ 08753
Phone (732) 240-2277

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1689685232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 ELTON ADELPHIA RD",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288616",
            "telephone_number": "732-740-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST BLDG B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-303-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRYNOWSKI",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "26N007829700",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00183300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.