Individual provider Active NPI

Jenna Petrera, CRNA

  • Certified Registered Nurse Anesthetist
  • Valhalla, NY
National Provider Identifier
1912389362
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
604836 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 557-1850
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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 604836 NY
Certified Registered Nurse Anesthetist 367500000X 604836 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

11781 Lee Jackson Memoiral Highway
Suite 550
Fairfax, VA 22033-3309
Phone (703) 295-9360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150917000260 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032426408 Reassigns benefits to 2 organizations

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
Hudson Health Anesthesia PLLCGroup PAC ID 1052702883, 49 clinicians

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 490-7000

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (914) 737-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
604836NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jul 1, 2015 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jul 1, 2015 Accepting new patients
Hudson Health Anesthesia PLLC CurrentSince Jul 1, 2022 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Past Accepting new patients

Locations

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

6 Front St
Newburgh, NY 12550

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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.

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1912389362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMOIRAL HIGHWAY",
            "address_2": "SUITE 550",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-557-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRERA",
        "first_name": "JENNA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "604836",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "604836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.