Active NPI
Timothy Pitta, CRNA
- Certified Registered Nurse Anesthetist
- New York, NY
National Provider Identifier
1821512914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 26NJ01478700
- Practice address
- 1275 York Ave
New York, NY 10065-6007 - Phone
- (212) 639-2000
- NPI assigned
- Jul 31, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 26NR19229200 | NJ | |
| Registered Nurse | 163W00000X | 652953-1 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 26NJ01478700 | NJ | Primary |
Addresses
Primary practice location
1275 York Ave
New York, NY 10065-6007
Mailing address
74 Norwood Ave
Glen Rock, NJ 07452-1430
Phone (631) 827-6734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 652953-1 | NY | MD | Registered Nurse |
| 26NJ01478700 | NJ | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Anesthesiology Group | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Shrewsbury Ambulatory Anesthesia LLC | Current | Accepting new patients |
Locations
655 Shrewsbury Ave
Shrewsbury, NJ 07702
Phone (732) 450-6000
633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- New York, NY
- NPI 1467423020
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Shrewsbury, NJ
- NPI 1356691885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1821512914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 NORWOOD AVE",
"city": "GLEN ROCK",
"state": "NJ",
"postal_code": "074521430",
"telephone_number": "631-827-6734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656007",
"telephone_number": "212-639-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTA",
"first_name": "TIMOTHY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-31",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NJ",
"license": "26NR19229200",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "652953-1",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NJ",
"license": "26NJ01478700",
"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 May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.