Individual provider Active NPI

Jillian M Guzzardo, CRNA

  • Certified Registered Nurse Anesthetist
  • Rockport, ME
National Provider Identifier
1871903393
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA203080 Issued in ME
Practice address
6 Glen Cove Dr
Rockport, ME 04856-4272
Phone
(207) 301-8000
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN597580 PA
Certified Registered Nurse Anesthetist 367500000X RNA203080 ME Primary

Addresses

Primary practice location

6 Glen Cove Dr
Rockport, ME 04856-4272

Mailing address

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (917) 608-5485

Other practice location 1

51 N 39th St
223 Wright Saunders
Philadelphia, PA 19104-2640
Phone (215) 662-8244

Other names 1

  • Jillian M Klunk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140616000707 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234353194 Reassigns benefits to 1 organization
I20210318000312 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234353194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 921-8969

Hospital & facility affiliations

  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNA203080MEMDCertified Registered Nurse Anesthetist
RN597580PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Mainehealth CurrentSince Mar 1, 2021 Accepting new patients
Mainehealth Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Central Maine Medical Center CurrentSince Nov 30, 2021 Accepting new patients
Central Maine Medical Center CurrentSince Nov 30, 2021 Accepting new patients

Locations

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 8

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 1

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1871903393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLEN COVE DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564272",
            "telephone_number": "917-608-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GLEN COVE DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564272",
            "telephone_number": "207-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 N 39th St",
            "address_2": "223 Wright Saunders",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191042640",
            "country_code": "US",
            "telephone_number": "215-662-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZZARDO",
        "first_name": "JILLIAN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN597580",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA203080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "KLUNK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.