Individual provider Active NPI

Sara Margaret Shirley

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
National Provider Identifier
1811560667
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ14863600 Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(800) 843-2384
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR24971800 NJ
Registered Nurse 163W00000X 167755 CT
Certified Registered Nurse Anesthetist 367500000X 26NJ14863600 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

19 Wayne Blvd
Madison, NJ 07940-1522
Phone (973) 224-9252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108006100 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315398922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7000

Hospital & facility affiliations

  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
167755CTMDRegistered Nurse
26NR24971800NJMDRegistered Nurse
26NJ14863600NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Nov 28, 2023 Accepting new patients

Locations

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Organizations & group practices 1

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 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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1811560667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WAYNE BLVD",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401522",
            "telephone_number": "973-224-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "800-843-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "SARA",
        "middle_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR24971800",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "167755",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ14863600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

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