Individual provider Active NPI

Anna V Romanov, CRNA

  • Certified Registered Nurse Anesthetist
  • Vineland, NJ
National Provider Identifier
1922192830
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00244600 Issued in NJ
Practice address
1505 W Sherman Ave
Vineland, NJ 08360-6912
Phone
(215) 442-5085
Fax
(856) 641-7668
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 26NJ00244600 NJ Primary
Registered Nurse 163W00000X 26NO12079900 NJ

Addresses

Primary practice location

1505 W Sherman Ave
Vineland, NJ 08360-6912

Mailing address

PO Box 650782
Dallas, TX 75265-0782
Phone (302) 733-0806

Other identifiers 2

IdentifierTypeStateIssuer
P00724840OtherNJRAILROAD MEDICARE PTAN
075886OtherNJAANA NUMBER

Other names 1

  • Anna V Petrenko Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000668 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315043858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-8000

901 W Main St
Freehold, NJ 07728-2537
Phone (732) 431-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NO12079900NJMDRegistered Nurse
26NJ00244600NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC CurrentSince Jun 4, 2017 Accepting new patients
Haverford Anesthesia Associates-NJ, P.C. Past Accepting new patients

Locations

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

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 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1922192830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650782",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650782",
            "telephone_number": "302-733-0806",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606912",
            "telephone_number": "215-442-5085",
            "fax_number": "856-641-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOV",
        "first_name": "ANNA",
        "middle_name": "V",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00244600",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NO12079900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00724840",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA NUMBER",
            "identifier": "075886",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "PETRENKO",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.