Individual provider Active NPI

Gregory J Makuch, CRNA

  • Certified Registered Nurse Anesthetist
  • Harrisburg, PA
National Provider Identifier
1710055306
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN514477L Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 782-5118
Fax
(717) 782-5854
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN514477L PA Primary

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612

Other identifiers 2

IdentifierTypeStateIssuer
MS1942927OtherPAHIGHMARK BS
076138OtherPAPA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmakuch17287@phsdirect.pinnaclehealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071219000023 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527158211 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Anesthesia Associates, LTDGroup PAC ID 6305758038, 12 clinicians

Practice addresses (Care Compare)

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3282

2015 Technology Pkwy
Mechanicsburg, PA 17050-9414
Phone (717) 791-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN514477LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 10, 2023 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC CurrentSince Apr 1, 2018 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2018 Accepting new patients
Riverside Anesthesia Associates, LTD CurrentSince Oct 15, 2023 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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

1 Rutherford Rd
Ste 101
Harrisburg, PA 17109
Phone (717) 545-5256

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

2015 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2474

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

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

Organizations & group practices 4

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 2

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1710055306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKUCH",
        "first_name": "GREGORY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN514477L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "MS1942927",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "076138",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmakuch17287@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.