Individual provider Active NPI

Paul R Jaselskis, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Mechanicsburg, PA
National Provider Identifier
1699701920
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN507048L Issued in PA
Practice address
461 Nursery Dr N
Mechanicsburg, PA 17055-7017
Phone
(717) 795-1977
NPI assigned
Jun 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN507048L PA Primary
Certified Registered Nurse Anesthetist 367500000X 26NR08840300 NJ

Addresses

Primary practice location

461 Nursery Dr N
Mechanicsburg, PA 17055-7017

Mailing address

461 Nursery Dr N
Mechanicsburg, PA 17055-7017
Phone (717) 795-1977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190315000566 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597843870 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR08840300NJMDCertified Registered Nurse Anesthetist
RN507048LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwood Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2019 Accepting new patients
Northwood Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2019 Accepting new patients
NMG Southpark Services, LLC Nurse Anesthetist, Certified Registered CurrentSince May 11, 2011 Accepting new patients
Northwood Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Mid-Atlantic Anesthesia Associates PA Past Accepting new patients

Locations

3291 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 725-5800

1350 E Venice Ave
Venice, FL 34285
Phone (941) 484-2030

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699701920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 NURSERY DR N",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170557017",
            "telephone_number": "717-795-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 NURSERY DR N",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170557017",
            "telephone_number": "717-795-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASELSKIS",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN507048L",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR08840300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.