Individual provider Active NPI

Keisha Alix Hampden

  • Anesthesiology Physician
  • Jersey City, NJ
National Provider Identifier
1992316707
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
129950 Issued in PR
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

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
CONNECT URL Hampden

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 PC 570 clinicians
Canj Anesthesia LLC 75 clinicians

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 Hospital, Hackensack, NJ, CCN 310001
  • Hudson Regional Hospital Hospital, Secaucus, NJ, CCN 310118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7855658NYMDRegistered Nurse
129950PRMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients
Prime Healthcare Services - St. Mary'S Passaic LLC CurrentSince Oct 10, 2022 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Sep 7, 2025 Accepting new patients
Prime Healthcare Services - St. Mary'S Passaic, LLC CurrentSince Oct 10, 2022 Accepting new patients
Canj Anesthesia LLC Anesthesiology CurrentSince Feb 6, 2025 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.

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.

Verify at the official NPI Registry.