NPIMap

Individual provider Active NPI

Lynda L Jakubco, CRNA

  • Certified Registered Nurse Anesthetist
  • Pottsville, PA
National Provider Identifier
1720198906
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN323767L Issued in PA
Practice address
420 S Jackson St
Pottsville, PA 17901-3625
Phone
(570) 621-5000
Fax
(570) 621-5589
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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 RN323767L PA Primary

Addresses

Primary practice location

420 S Jackson St
Pottsville, PA 17901-3625

Mailing address

420 S Jackson St
Pottsville, PA 17901-3625
Phone (570) 621-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050901000535 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587696356 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Hazleton Anesthesia Services PCGroup PAC ID 2365584141, 35 clinicians

Practice addresses (Care Compare)

330 Main St
Dickson City, PA 18519-1691
Phone (610) 402-6164

700 E Broad St
Hazelton, PA 18201-6835
Phone (570) 501-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2024 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Hazleton Anesthesia Services, P.C. CurrentSince Mar 12, 2015 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2024 Accepting new patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Sep 15, 2019 Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

2128 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (484) 224-9970

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

330 Main St
Scranton, PA 18519
Phone (570) 330-5000

Organizations & group practices 7

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 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1720198906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S JACKSON ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013625",
            "telephone_number": "570-621-5000",
            "fax_number": "570-621-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S JACKSON ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013625",
            "telephone_number": "570-621-5000",
            "fax_number": "570-621-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBCO",
        "first_name": "LYNDA",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN323767L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.