Individual provider Active NPI

Jerry Varughese, CRNA

  • Certified Registered Nurse Anesthetist
  • Valhalla, NY
National Provider Identifier
1790145944
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
686416 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-7000
NPI assigned
Mar 1, 2016
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 686416 NY
Certified Registered Nurse Anesthetist 367500000X 686416 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7000

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190215001228 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163760281 Reassigns benefits to 2 organizations
I20260126002009 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163760281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergen Anesthesia Group, P.C.Group PAC ID 6608861794, 61 clinicians
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 490-7000

4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (201) 847-9320

967 N Broadway
Yonkers, NY 10701-1301
Phone (914) 666-8866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
686416NYMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen Anesthesia Group, P.C. CurrentSince Dec 14, 2025 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Aug 19, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Dec 31, 2018 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Current Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

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

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.

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1790145944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-01",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "686416",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "686416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.