KYUNGMOON ROH CRNA
NPI 1245986140
Nurse Anesthetist, Certified Registered in Hackensack, NJ
About Kyungmoon Roh Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYUNGMOON ROH CRNA (NPI 1245986140) is an individual nurse anesthetist, certified registered in Hackensack, New Jersey, licensed in New York (680524) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and maintains a secondary practice location in Flushing.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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
Kyungmoon Roh 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.
Medicare Billing Reassignments
5Medicare enrollment records show Kyungmoon Roh reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hackensack, NJ 07601
- Reassigned Medicare billing, New Jersey enrollment
- 781 clinicians in this Medicare group
Passaic, NJ 07055
- Reassigned Medicare billing, New Jersey enrollment
- 74 clinicians in this Medicare group
New York, NY 10029
- Reassigned Medicare billing, New York enrollment
- 245 clinicians in this Medicare group
New York, NY 10028
- Reassigned Medicare billing, New York enrollment
- 140 clinicians in this Medicare group
New York, NY 10065
- Reassigned Medicare billing, New York enrollment
- 384 clinicians in this Medicare group
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 2
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hackensack University Medical Center
Acute Care Hospitals · Hackensack, NJNew York-Presbyterian/Queens
Acute Care Hospitals · Flushing, NYNy Eye And Ear Infirmary Of Mount Sinai
Acute Care Hospitals · New York, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 07601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
HACKENSACK, NJ 07601
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kyungmoon Roh's NPI number?
The NPI number for Kyungmoon Roh is 1245986140. It was assigned to this individual provider in the NPPES registry on March 1, 2022.
Where is Kyungmoon Roh located?
Kyungmoon Roh practices at 30 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (551) 996-2419.
What is Kyungmoon Roh's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kyungmoon Roh enrolled in Medicare?
Yes. Kyungmoon Roh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kyungmoon Roh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kyungmoon Roh reassigns Medicare benefits to 5 organizations: New Jersey Healthcare Specialists PC (Hackensack, NJ), Prime Healthcare Services - St. Mary's Passaic, LLC (Passaic, NJ), Icahn School Of Medicine At Mount Sinai (New York, NY), Centurion Midtown Anesthesia PLLC (New York, NY) and Weill Medical College Of Cornell (New York, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyungmoon Roh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kyungmoon Roh affiliated with any hospitals?
According to CMS data, Kyungmoon Roh is affiliated with Hackensack University Medical Center, New York-Presbyterian/Queens and Ny Eye And Ear Infirmary Of Mount Sinai.
When was this NPI record last updated?
The NPPES record for Kyungmoon Roh was last updated on September 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kyungmoon Roh, CRNA · NPI 1245986140
Nurse Anesthetist, Certified Registered physician in Hackensack, New Jersey. Individual provider, active in the CMS NPPES registry since March 1, 2022.
## Identity
- **NPI:** 1245986140 (Entity type: Individual)
- **Enumerated:** March 1, 2022
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 680524 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 30 PROSPECT AVE, Hackensack, NJ 07601-1915
- **Phone:** (551) 996-2419
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): New Jersey Healthcare Specialists PC (NPI 1174585780, Hackensack, NJ); Prime Healthcare Services - St. Mary's Passaic, LLC (NPI 1730508250, Passaic, NJ); Icahn School Of Medicine At Mount Sinai (NPI 1447008446, New York, NY); Centurion Midtown Anesthesia PLLC (NPI 1750087854, New York, NY); Weill Medical College Of Cornell (NPI 1164768305, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** September 28, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1245986140) · Data from the CMS NPPES public registry.