Individual provider Active NPI

Elizabeth Johansson, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
National Provider Identifier
1942428883
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NO09780800 Issued in NJ
Practice address
30 Bergen St
Newark, NJ 07107-3000
Phone
(973) 972-2513
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NO09780800 NJ Primary

Addresses

Primary practice location

30 Bergen St
Newark, NJ 07107-3000

Mailing address

26 Witherspoon St
Whitehouse Station, NJ 08889-3915
Phone (908) 534-4096

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000522 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961581616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University HospitalGroup PAC ID 5294636874, 77 clinicians

Practice addresses (Care Compare)

150 Bergen St
245 Dept of Anesthesiology
Newark, NJ 07101-2496
Phone (973) 972-7867

Hospital & facility affiliations

  • The University Hospital Hospital, Newark, NJ, CCN 310119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942428883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WITHERSPOON ST",
            "city": "WHITEHOUSE STATION",
            "state": "NJ",
            "postal_code": "088893915",
            "telephone_number": "908-534-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NO09780800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.