Individual provider Active NPI

Jane Kathryn Haslam, CRNA

  • Certified Registered Nurse Anesthetist
  • Bangor, ME
National Provider Identifier
1770535221
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AA083288 Issued in ME
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-4519
Fax
(207) 992-4132
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9180425 FL
Certified Registered Nurse Anesthetist 367500000X AA083288 ME Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

141 N Main St Ste 205
Brewer, ME 04412-2055
Phone (207) 973-4519

Other names 1

  • Jane Kathryn Kucinski Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000547 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921018151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cec LLC 9 clinicians
Eastern Maine Medical Center 659 clinicians

Practice addresses (Care Compare)

128 Bucksport Rd
Suite B
Ellsworth, ME 04605-2239
Phone (207) 667-6300

417 State St
Bangor, ME 04401-6639

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
71.71
Promoting interoperability
100
Improvement activities
40
Cost
69.07

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Merit-based Incentive Payment System (MIPS)

Final score
93.15 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.15

Merit-based Incentive Payment System (MIPS)

Final score
90.63 of 100Reported as group
Quality
77.69
Promoting interoperability
95
Improvement activities
40
Cost
78.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9180425FLMDCertified Registered Nurse Anesthetist
AA083288MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Anesthesia L.L.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2020 Accepting new patients
Cec, LLC CurrentSince Jan 20, 2017 Accepting new patients
Eastern Maine Medical Center CurrentSince Jun 5, 2006 Accepting new patients
Eastern Maine Medical Center CurrentSince Jun 5, 2006 Accepting new patients
Coastal Eye Surgery Center, LLC Past Accepting new patients
Sebasticook Valley Health Past Accepting new patients
Cesc, LLC Past Accepting new patients
Collier Anesthesia PA Past Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

455 Harlow St
Bangor, ME 04401
Phone (207) 992-4032

141 N Main St
Ste 205
Brewer, ME 04412
Phone (207) 992-4032

128 Bucksport Rd
#B
Ellsworth, ME 04605
Phone (207) 667-6300

128 Bucksport Rd
#A
Ellsworth, ME 04605
Phone (207) 667-6300

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

128 Bucksport Rd
Ellsworth, ME 04605
Phone (207) 667-6300

200 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 861-3000

325A Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 667-9690

Organizations & group practices 8

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 1

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1770535221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST STE 205",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122055",
            "telephone_number": "207-973-4519",
            "fax_number": "207-992-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-4519",
            "fax_number": "207-992-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "JANE",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9180425",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "AA083288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "KUCINSKI",
            "middle_name": "KATHRYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.