Individual provider Active NPI

Jeenu Mary Zacharias, CRNA

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1871044271
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6841 Issued in CT
Practice address
333 Cedar St, TMP3
Yale University, Department of Anesthesiology
New Haven, CT 06520-8051
Phone
(203) 737-1549
Fax
(203) 785-6664
NPI assigned
Oct 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 078356 CT
Certified Registered Nurse Anesthetist 367500000X 6841 CT Primary

Addresses

Primary practice location

333 Cedar St, TMP3
Yale University, Department of Anesthesiology
New Haven, CT 06520-8051

Mailing address

25 Broadmeadow Rd
Wallingford, CT 06492-6045
Phone (203) 300-0045

Other identifiers 2

IdentifierTypeStateIssuer
6841OtherCTAPRN LICENSE
078356OtherCTRN LICENSE

Other names 1

  • Jeenu Mary George Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124002752 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113209248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1450 Chapel St
New Haven, CT 06511-4440
Phone (203) 789-3000

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078356CTMDRegistered Nurse
6841CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Dec 6, 2016 Accepting new patients
Yale University CurrentSince Dec 6, 2016 Accepting new patients

Locations

333 Cedar St
#3
New Haven, CT 06510
Phone (203) 737-1549

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

Interoperability endpoints

  • Direct secure messaging: jzacharias182952@direct.ynhh.org

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.

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": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1871044271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BROADMEADOW RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064926045",
            "telephone_number": "203-300-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST, TMP3",
            "address_2": "YALE UNIVERSITY, DEPARTMENT OF ANESTHESIOLOGY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208051",
            "telephone_number": "203-737-1549",
            "fax_number": "203-785-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAS",
        "first_name": "JEENU",
        "middle_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "078356",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "6841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN  LICENSE",
            "identifier": "6841",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "078356",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEENU",
            "last_name": "GEORGE",
            "middle_name": "MARY",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.