Individual provider Active NPI

Jennifer Maria Gabrielatos, CRNA

  • Certified Registered Nurse Anesthetist
  • St. Louis, MO
National Provider Identifier
1922554591
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209015721 Issued in IL
Practice address
11133 Dunn Rd.
St. Louis, MO 63136
Phone
(314) 653-5000
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.376376 IL
Registered Nurse 163W00000X 2011016184 MO
Certified Registered Nurse Anesthetist 367500000X 2017003247 MO
Certified Registered Nurse Anesthetist 367500000X 209015721 IL Primary

Addresses

Primary practice location

11133 Dunn Rd.
St. Louis, MO 63136

Mailing address

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170215000324 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709169832 Reassigns benefits to 2 organizations
I20170411000114 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709169832 Reassigns benefits to 3 organizations

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
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.376376ILMDRegistered Nurse
2011016184MOMDRegistered Nurse
209015721ILMDCertified Registered Nurse Anesthetist
2017003247MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Aug 1, 2022 Accepting new patients
SSM Health Slu Hospital Anesthesia Physician Billing, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 10, 2023 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2017 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2 Memorial Dr
Alton, IL 62002
Phone (618) 462-0710

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1922554591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-653-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD.",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63136",
            "telephone_number": "314-653-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIELATOS",
        "first_name": "JENNIFER",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.376376",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2011016184",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2017003247",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209015721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.