Individual provider Active NPI

Jennifer J Jacobs, CRNA

  • Certified Registered Nurse Anesthetist
  • Boca Raton, FL
National Provider Identifier
1750497533
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3259022 Issued in FL
Practice address
501 Glades Rd
Boca Raton, FL 33432-1419
Phone
(561) 362-4400
Fax
(561) 362-4445
NPI assigned
Aug 22, 2006
Last updated
Feb 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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 3259022 FL Primary

Addresses

Primary practice location

501 Glades Rd
Boca Raton, FL 33432-1419

Mailing address

PO Box 862565
Orlando, FL 32886-2565
Phone (800) 248-1639

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070205000301 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456353473 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

501 Glades Rd
Boca Raton, FL 33432-1419
Phone (954) 939-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3259022FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Anesthesia Associates LLC CurrentSince Feb 1, 2015 Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Feb 1, 2015 Accepting new patients
South Florida Gastroenterology Associates PA PastSince Mar 3, 1997 Accepting new patients
Broad Midwest Anesthesia, LLC Past Accepting new patients

Locations

501 Glades Rd
Boca Raton, FL 33432
Phone (561) 362-4400

4675 Linton Blvd
Delray Beach, FL 33445
Phone (561) 381-4305

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

5301 N Dixie Hwy
Ste 100
Oakland Park, FL 33334
Phone (954) 771-3334

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

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, 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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1750497533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862565",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328862565",
            "telephone_number": "800-248-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321419",
            "telephone_number": "561-362-4400",
            "fax_number": "561-362-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "3259022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.