Active NPI
Keisha Alix Hampden
- Anesthesiology Physician
- Jersey City, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 129950
- Practice address
- 355 Grand St
Jersey City, NJ 07302-4321 - Phone
- (201) 915-2000
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 7855658 | NY | |
| Anesthesiology Physician | 207L00000X | 129950 | PR | Primary |
Addresses
Primary practice location
355 Grand St
Jersey City, NJ 07302-4321
Mailing address
309 Killough Cir
Birmingham, AL 35215-6907
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Hampden |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210317000096 | NJ | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4082020011 | Reassigns benefits to 3 organizations |
| I20251118004135 | NY | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4082020011 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New Jersey Healthcare Specialists PCCanj Anesthesia LLC
Practice addresses (Care Compare)
30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 488-0066
40 Prospect Ave
Hackensack, NJ 07601-1915
Phone (954) 939-5000
55 Mdwlands Pkwy
Secaucus, NJ 07094-2977
Phone (917) 681-4963
Hospital & facility affiliations
- Hackensack University Medical Center
- Hudson Regional Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7855658 | NY | MD | Registered Nurse |
| 129950 | PR | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Healthcare Specialists PC | Anesthesiology | Current | Accepting new patients |
| Prime Healthcare Services - St. Mary'S Passaic LLC | Current | Accepting new patients | |
| Sedation Vacation Perioperative Medicine PLLC | Current | Accepting new patients | |
| Prime Healthcare Services - St. Mary'S Passaic, LLC | Current | Accepting new patients | |
| Canj Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224
111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060
350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300
55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744
1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313
8745 Lake Street Rd
Le Roy, NY 14482
Phone (585) 267-7570
10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600
Organizations & group practices 5
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
- Hackensack, NJ
- NPI 1174585780
Anesthesiology, NJ
-
- General Acute Care Hospital
- Passaic, NJ
- NPI 1730508250
NJ
-
- General Acute Care Hospital
- Passaic, NJ
- NPI 1770901761
Hospital & facility affiliations 3
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": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1992316707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 KILLOUGH CIR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352156907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 GRAND ST",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073024321",
"telephone_number": "201-915-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMPDEN",
"first_name": "KEISHA",
"middle_name": "ALIX",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "7855658",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PR",
"license": "129950",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Hampden",
"affiliation": "N",
"address_1": "355 Grand St",
"city": "Jersey City",
"state": "NJ",
"country_code": "US",
"postal_code": "073024321",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.