Individual provider Active NPI

Julia Pennisi, CRNA

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1770578205
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00209400 Issued in NJ
Practice address
1 Cooper PLZ Dept of
Camden, NJ 08103-1461
Phone
(856) 342-2425
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 NR103753 NJ
Certified Registered Nurse Anesthetist 367500000X 26NJ00209400 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ Dept of
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

102E Centre Blvd
Marlton, NJ 08053-4129
Phone (856) 988-6260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000138 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587639646 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 853-7450

30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 488-0066

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00209400NJMDCertified Registered Nurse Anesthetist
NR103753NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC CurrentSince Jan 11, 2015 Accepting new patients
Allied Digestive Health, LLC CurrentSince Jan 6, 2020 Accepting new patients
Princeton Healthcare Affiliated Physicians PC Current Accepting new patients
Cooper Anesthesia Associates, PC CurrentSince Mar 5, 2024 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Mar 28, 2020 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Mar 28, 2020 Accepting new patients
Voorhees Pain Consultants PA Past Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients
Cooper Physician Offices, PA Past Accepting new patients
Virtua Surgical Group, P.a Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

501 Fellowship Rd
Ste 102
Mount Laurel, NJ 08054
Phone (856) 380-1768

1 Washington Blvd
Ste A
Trenton, NJ 08691
Phone (609) 448-4353

900 Centennial Blvd
Ste E
Voorhees, NJ 08043
Phone (856) 325-6505

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

218C Sunset Rd
Willingboro, NJ 08046
Phone (609) 877-0400

Organizations & group practices 10

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 3

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1770578205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ DEPT OF",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102E Centre Blvd",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534129",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNISI",
        "first_name": "JULIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "NR103753",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00209400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.