BREAKWATER ANESTHESIA, INC. (NPI# 1356819791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356819791 |
| Entity Type | Organization |
| Organization Name | BREAKWATER ANESTHESIA, INC. |
| Practice Address |
900 Cummings Ctr Ste 117t Beverly MA 01915-6183 |
| Mailing Address |
7 Elwell St Unit 2 Gloucester MA 01930-2905 |
| Practice Telephone | 6179225655 |
| Mailing Telephone | 6179225655 |
| Enumeration Date | 2018-11-04 |
| Last Update Date | 2019-01-08 |
| Authorized Official Name | JACOB BEVILACQUA (CO-OWNER) |
| Authorized Official Telephone | 6179225655 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI - JACOB BEVILACQUA | 1992048870 | 01 | |
| NPI - PATRICK KEATING | 1679916142 | 01 |
| Street Address |
900 CUMMINGS CTR STE 117T |
| City | BEVERLY |
| State | MA |
| Zip Code | 01915-6183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366921322 | Melanie Mcgilloway | Nurse Practitioner | 900 Cummings Ctr Ste 117t, Beverly, MA 01915-6183 | 2018-08-10 |
| 1831716976 | Nora Kurbaj | Physician Assistant | 900 Cummings Ctr Ste 117t, Beverly, MA 01915-6183 | 2020-07-05 |
| 1467078006 | Marco Palazzolo | Nurse Practitioner | 900 Cummings Ctr Ste 117t, Beverly, MA 01915-6183 | 2020-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377253 | Janice E. Schwartz | Psychologist | 100 Cummings Center, 232 C, Beverly, MA 01915 | 2020-05-14 |
| 1720625452 | Campos Dental Care PC | Dentist | 127 Dodge Street, Beverly, MA 01915 | 2019-12-02 |
| 1144781477 | Nutrimedy | Dietitian, Registered | 6 Oceanside Drive, Beverly, MA 01915 | 2019-03-28 |
| 1376001073 | Benjamin David Stebbings | Counselor | 199 Rosewood Dr. Suite 250, Beverly, MA 01915 | 2019-03-12 |
| 1376000455 | Patrick Matthew Noble | Occupational Therapist | Peer Projects - Therapy From The Heart, 100 Cummings Center Suite 350g, Beverly, MA 01915 | 2019-02-26 |
| 1174007900 | Nicole Morreo | Psychologist | 480 Rantoul St., 208, Beverly, MA 01915 | 2018-09-18 |
| 1891282299 | Jeanne Tomich | Psychologist | 110 Hart St., Beverly, MA 01915 | 2018-04-20 |
| 1518469089 | Kathleen L Golemon | Specialist | 100 Cummings Center Suite 158-d, Beverly, MA 01915 | 2018-03-01 |
| 1629582556 | Sarah Elizabeth Tsouvalas | Nurse Practitioner | 900 Cummings Center, Suite 111w, Lahey Health Primary Care, Beverly, Beverly, MA 01915 | 2017-11-30 |
| 1235657339 | Kathleen Ann Downey | Registered Nurse | Element Care, 166d Cummings Center, Beverly, MA 01915 | 2017-09-08 |
| Find all providers in zip 01915 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336595065 | Sanjeev Wadhwa | Nurse Anesthetist, Certified Registered | 85 Herrick St, Beverly, MA 01915-1790 | 2016-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015036 | Olivia Marie Mahoney | Nurse Anesthetist, Certified Registered | 163 Libbey Industrial Pkwy Ste 301, Weymouth, MA 02189-3137 | 2020-02-14 |
| 1679132906 | Michael Schinis | Nurse Anesthetist, Certified Registered | 15 Saint Marks Rd Apt 2, Boston, MA 02124-2986 | 2019-06-11 |
| 1154886810 | Pioneer Sedation Pllc | Nurse Anesthetist, Certified Registered | 3550 Main St Ste 103, Springfield, MA 01107-1077 | 2019-02-07 |
| 1457830515 | Jenna Fairlie | Nurse Anesthetist, Certified Registered | 181 Park Ave Ste 5, W Springfield, MA 01089-3365 | 2018-08-09 |
| 1972004695 | Natasha Nicole Pittman | Nurse Anesthetist, Certified Registered | 12 Aitchison St Apt A, Worcester, MA 01604-1636 | 2018-02-27 |
| 1609301472 | Rebecca J Prange | Nurse Anesthetist, Certified Registered | 2 Ladds Way, Scituate, MA 02066-1920 | 2017-04-28 |
| 1467804856 | Jobina Susannah Ruiz | Nurse Anesthetist, Certified Registered | 1486 Commonwealth Ave, Apt 6, Brighton, MA 02135-4526 | 2016-07-08 |
| 1831547611 | Christopher Gruber | Nurse Anesthetist, Certified Registered | 7 Riverbank Ave, Danvers, MA 01923-3208 | 2016-06-02 |
| 1063867802 | Gerald F. Finerty IIi | Nurse Anesthetist, Certified Registered | 163 Libbey Pkwy Ste 301, Weymouth, MA 02189 | 2016-04-29 |
| 1295193431 | David Pinkney | Nurse Anesthetist, Certified Registered | 82 N Main St Apt 3125, Natick, MA 01760-3474 | 2016-02-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.