Individual provider Active NPI

Jaclyn McDonald, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlantis, FL
National Provider Identifier
1992291595
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9319633 Issued in FL
Practice address
5301 S Congress Ave
Atlantis, FL 33462-1197
Phone
(561) 965-7300
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN716966 PA
Certified Registered Nurse Anesthetist 367500000X 514500 FL
Certified Registered Nurse Anesthetist 367500000X APRN9319633 FL Primary

Addresses

Primary practice location

5301 S Congress Ave
Atlantis, FL 33462-1197

Mailing address

7049 Via Leonardo
Lake Worth, FL 33467-5236
Phone (561) 504-3324

Other practice location 1

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone (610) 402-8000

Other identifiers 1

IdentifierTypeStateIssuer
00OtherNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190206000119 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355689035 Reassigns benefits to 2 organizations
I20190724002177 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355689035 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Nazareth Endoscopy Center, LLCGroup PAC ID 6002245776, 11 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
LVPG General in Patient Pediatrics
Allentown, PA 18103-6202
Phone (610) 402-6700

2401 Northampton St
Suite 220
Easton, PA 18045-2764
Phone (610) 756-9900

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
514500FLMDCertified Registered Nurse Anesthetist
APRN9319633FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 29, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 29, 2023 Accepting new patients
Grove City Anesthesia & Pain Management, PLLC CurrentSince Apr 7, 2022 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Jun 16, 2024 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Nov 1, 2021 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Professional Anesthesia Services of North America P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2022 Accepting new patients
Nazareth Endoscopy Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 12, 2020 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Nov 1, 2021 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2019 Accepting new patients

Locations

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

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

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300

2401 Northampton St
Ste 220
Easton, PA 18045
Phone (610) 756-9900

20 Community Dr
Easton, PA 18045
Phone (610) 258-1844

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

100 E Lancaster Ave
Ste 158
Wynnewood, PA 19096
Phone (484) 206-5800

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1992291595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7049 VIA LEONARDO",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334675236",
            "telephone_number": "561-504-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 S CONGRESS AVE",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621197",
            "telephone_number": "561-965-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036202",
            "country_code": "US",
            "telephone_number": "610-402-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JACLYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN716966",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "514500",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9319633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "00",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.