Individual provider Active NPI

Dmitry Feldberg, SRNA

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1770041360
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
604239 Issued in NY
Practice address
560 W 168TH St
New York, NY 10032-3917
Phone
(212) 305-5756
NPI assigned
Mar 4, 2019
Last updated
Mar 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 604239 NY Primary

Addresses

Primary practice location

560 W 168TH St
New York, NY 10032-3917

Mailing address

560 W 168TH St
New York, NY 10032-3917
Phone (212) 305-5756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201228000448 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375955966 Reassigns benefits to 1 organization
I20240701001950 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375955966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University HospitalGroup PAC ID 5294636874, 77 clinicians
Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians

Practice addresses (Care Compare)

150 Bergen St
245 Dept of Anesthesiology
Newark, NJ 07101-2496
Phone (973) 972-7867

495 Jack Martin Blvd
Suite 1
Brick, NJ 08724-7778
Phone (732) 836-9800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
604239NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital CurrentSince Apr 11, 2024 Accepting new patients
Digestive Diseases Diagnostic & Treatment Center LLC CurrentSince Apr 26, 2021 Accepting new patients
Parkway Anesthesia Associates LLC CurrentSince Aug 10, 2024 Accepting new patients
University Hospital Nurse Anesthetist, Certified Registered CurrentSince Apr 11, 2024 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Aug 1, 2022 Accepting new patients

Locations

495 Jack Martin Blvd
Ste 1
Brick, NJ 08724
Phone (732) 836-9800

41 Arthur St
East Brunswick, NJ 08816
Phone (201) 703-2900

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

150 Bergen St
#E245
Newark, NJ 07103
Phone (973) 972-7867

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

7 Southwoods Blvd
Ste 4
Albany, NY 12211

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

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

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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 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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1770041360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323917",
            "telephone_number": "212-305-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323917",
            "telephone_number": "212-305-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDBERG",
        "first_name": "DMITRY",
        "credential": "SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "604239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.