Active NPI
Jacob Gregory Cooley, DNP, CRNA
- Certified Registered Nurse Anesthetist
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 10264
- Practice address
- 1 Boston Medical Ctr PL
Boston, MA 02118-2908 - Phone
- (617) 638-6950
- Fax
- (617) 638-6966
- NPI assigned
- Jun 12, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 10264 | WI | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | RN697361 | PA |
Addresses
Primary practice location
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Mailing address
3066 N Station St
Verona, WI 53593-8722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, WA, OK
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN697361 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stillwater Medical Center Authority | Anesthesiology | Current | Accepting new patients |
| Stillwater Medical Center Authority | Current | Accepting new patients | |
| Anesthesia Associates of New Mexico P C | Current | Accepting new patients | |
| Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC | Anesthesiology | Current | Accepting new patients |
Locations
2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804
8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000
1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124
417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770
1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480
888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Stillwater, OK
- NPI 1558377135
Anesthesiology
-
- Specialist
- Albuquerque, NM
- NPI 1912900754
-
- Anesthesiology Physician
- Richland, WA
- NPI 1013940253
-
- Family Medicine Physician
- Perry, OK
- NPI 1407729361
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Stillwater, OK
- NPI 1164494027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1821528969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3066 N STATION ST",
"city": "VERONA",
"state": "WI",
"postal_code": "535938722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BOSTON MEDICAL CTR PL",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182908",
"telephone_number": "617-638-6950",
"fax_number": "617-638-6966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "JACOB",
"middle_name": "GREGORY",
"credential": "DNP, CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "10264",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN697361",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.