Jacob Emanuel Bevilacqua, RN, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

26NR15502700 Issued in NJ

Practice address

1 Cooper PLZ
Camden, NJ 08103-1461

Phone

(856) 342-2000

NPI assigned

Mar 29, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marion Communtiy Hospital Hospital, Ocala, FL, CCN 100212

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/imedicware_cfei

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.

• Sheridan Healthcorp Inc

  • Anesthesiology Physician
  • Okeechobee, FL
  • NPI 1629781711

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Central Florida Eye Institute PL

  • Ophthalmology Physician
  • Ocala, FL
  • NPI 1609876986
  Medicare reassignment NPD
• Solace Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Oxford, FL
  • NPI 1962046151

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Central Florida Eye Institute PL

  • Eyewear Supplier
  • Ocala, FL
  • NPI 1659371714
  NPD
• Sheridan Healthcorp Inc

  • Anesthesiology Physician
  • North Miami Beach, FL
  • NPI 1184607228

  Nurse Anesthetist, Certified Registered

  NPD
• Sheridan Healthcorp, Inc.

  • Anesthesiology Physician
  • North Miami Beach, FL
  • NPI 1578429460
  NPD
• Advanced Surgery Center of Oxford

  • Ambulatory Surgical Clinic/Center
  • Oxford, FL
  • NPI 1033760723
  NPD (past)
• Integrated Gastroenterology Consultants, PC

  • Physical Therapist
  • North Chelmsford, MA
  • NPI 1396075123
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marion Community Hospital, Inc.

  • General Acute Care Hospital
  • Ocala, FL
  • NPI 1841237930
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1992048870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-356-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "JACOB",
        "middle_name": "EMANUEL",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR15502700",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2297562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Bernhard
• Maria C. Berrios
• Annette Berry, APN
• Julie Berry, LSW
• Jessica C Bethell Barsocchi, P.A.
• John E Bevilacqua, MD
• Jesus Bey
• Monika Bhalla, M.D.
• Nikhil Bhalla, MD
• Amit Bhalodia, D.O

• Certified Registered Nurse Anesthetist in Camden, NJ
• Providers in Camden, NJ by specialty
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.