NPIMap

Individual provider Active NPI

Jennifer Elizabeth Cerio, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1730587395
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
663209 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7828
Fax
(315) 470-5811
NPI assigned
Dec 15, 2014
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 663209 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

17976 Almendro LN
San Diego, CA 92127-1137
Phone (858) 243-0955

Other names 1

  • Jennifer Elizabeth Pedersen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190228002589 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779800552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Centers of Urology and Surgery LLC CurrentSince Sep 1, 2020 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2019 Accepting new patients
Coastal Carolina Centers of Urology and Surgery LLC CurrentSince Dec 18, 2023 Accepting new patients

Locations

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

822 Farrar Dr
Conway, SC 29526
Phone (843) 347-9587

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1730587395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17976 ALMENDRO LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271137",
            "telephone_number": "858-243-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7828",
            "fax_number": "315-470-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERIO",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "663209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PEDERSEN",
            "middle_name": "ELIZABETH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.