JACQUELINE M HAVRILIAK CRNA
NPI 1063457760
Nurse Anesthetist, Certified Registered in Johnson City, NY

Q: What is Jacqueline Havriliak's NPI number?

The NPI number for Jacqueline Havriliak is 1063457760. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Q: What is Jacqueline Havriliak's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since June 17, 2006Accepts Medicare Assignment

156 CORLISS AVE, SUITE 107, JOHNSON CITY, NY 13790(607) 763-6735 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jacqueline M Havriliak Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE M HAVRILIAK CRNA (NPI 1063457760) is an individual nurse anesthetist, certified registered in Johnson City, New York, licensed in Pennsylvania (RN246320L) and active in the NPI registry since June 2006. She is a graduate of Other (1991).

NPPES Registry Identity

NPI1063457760

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameJACQUELINE M HAVRILIAKCredential: CRNA

Location Address156 CORLISS AVE, SUITE 107Johnson City, NY 13790-2060

Mailing Address156 Corliss Ave, Suite 107Johnson City, NY 13790-2060 · (607) 763-6735

Phone(607) 763-6735

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateJune 17, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1063457760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in PA · RN246320L

Definition

(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.

156 CORLISS AVE, Johnson City, NY 13790

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline M Havriliak Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850293457

PECOS Enrollment IDI20040123000622

Medicare Billing Reassignments

Medicare enrollment records show Jacqueline Havriliak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bryn Mawr Medical Specialists Association

148 mi

Multi-Specialty

825 OLD LANCASTER RD, SUITE 320
Bryn Mawr, PA 19010

Reassigned Medicare billing, Pennsylvania enrollment
171 clinicians in this Medicare group

NPI 1841226099 (610) 527-3800

Associates In Anesthesia, Inc.

156 mi

Anesthesiology

1212 BALTIMORE PIKE STE 200
Chadds Ford, PA 19317

Reassigned Medicare billing, Pennsylvania enrollment
251 clinicians in this Medicare group

NPI 1942281191 (610) 874-6448

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for exam of colon using an endoscope 00812

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

211 services211 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

73 services70 patients

Anesthesia for procedure on small and large bowel using an endoscope 00813

Anesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.

56 services56 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

42 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13790 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HOTEK KIM MD

Anesthesiology