Active NPI
Olga Tkachenko
- Certified Registered Nurse Anesthetist
- Wayne, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 26NJ01293100
- Practice address
- 224 Hamburg Tpke
Wayne, NJ 07470-2168 - Phone
- (973) 942-6900
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 622678 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 26NJ01293100 | NJ | Primary |
Addresses
Primary practice location
224 Hamburg Tpke
Wayne, NJ 07470-2168
Mailing address
3545 79TH St Apt 5E
Jackson Heights, NY 11372-4836
Phone (347) 350-4934
Other practice location 1
560 W 168th St
New York, NY 10032-3917
Phone (212) 305-5756
Other practice location 2
703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
350 Engle St
Englewood, NJ 07631-1808
Phone (201) 871-6073
Hospital & facility affiliations
- Englewood Hospital and Medical Center
- St Joseph'S University Medical Center Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01293100 | NJ | MD | Certified Registered Nurse Anesthetist |
| 622678 | NY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia of New Jersey LLC | Current | Accepting new patients | |
| Northern Valley Anesthesiology, P.a. | Current | Accepting new patients |
Locations
350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073
300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
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.
-
- Anesthesiology Physician
- Englewood, NJ
- NPI 1245289487
-
- Anesthesiology Physician
- Brick, NJ
- NPI 1548433048
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Englewood, NJ
- NPI 1083612881
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1972162089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3545 79TH ST APT 5E",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113724836",
"telephone_number": "347-350-4934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 HAMBURG TPKE",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702168",
"telephone_number": "973-942-6900"
}
],
"practiceLocations": [
{
"address_1": "560 W 168th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100323917",
"country_code": "US",
"telephone_number": "212-305-5756",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "703 Main St",
"address_purpose": "LOCATION",
"city": "Paterson",
"state": "NJ",
"postal_code": "075032621",
"country_code": "US",
"telephone_number": "973-754-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TKACHENKO",
"first_name": "OLGA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "622678",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NJ",
"license": "26NJ01293100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.