NPIMap

Individual provider Active NPI

Nicole Marie Juhasz, CRNA

  • Certified Registered Nurse Anesthetist
  • Campbellsville, KY
National Provider Identifier
1750652186
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1107211 Issued in KY
Practice address
1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone
(270) 932-3694
Fax
(270) 932-2154
NPI assigned
Jan 17, 2012
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Hospital & facility affiliations 22

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

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Louisville Physicians Inc 1,438 clinicians

Practice addresses (Care Compare)

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 852-8266

Hospital & facility affiliations

  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20120309000394 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628237666 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1107211KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jul 5, 2014 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 5, 2014 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

401 E Chestnut St
Unit 610
Louisville, KY 40202
Phone (502) 588-4450

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1107211 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615

Mailing address

PO Box 180
Campbellsville, KY 42719-0180
Phone (270) 932-3694

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1107211OtherKYKENTUCKY BOARD OF NURSING

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 20, 2019.

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1750652186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427190180",
            "telephone_number": "270-932-3694",
            "fax_number": "270-932-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-932-3694",
            "fax_number": "270-932-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUHASZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1107211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF NURSING",
            "identifier": "1107211",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.