JACOB ALLEN RODERICK CRNA
NPI 1538406871
Nurse Anesthetist, Certified Registered in Morgantown, WV

Q: What is Jacob Roderick's NPI number?

The NPI number for Jacob Roderick is 1538406871. It was assigned to this individual provider in the NPPES registry on January 7, 2013.

Q: What is Jacob Roderick's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Roderick was last updated on November 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since January 07, 2013Accepts Medicare Assignment

88.31/100

CMS Quality Rating

1200 J D ANDERSON DR, MORGANTOWN, WV 26505(706) 650-0705 Get Directions Write a Review

NPPES record last updated: November 15, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Jacob Allen Roderick Crna NPPES

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

JACOB ALLEN RODERICK CRNA (NPI 1538406871) is an individual nurse anesthetist, certified registered in Morgantown, West Virginia, licensed in West Virginia (72425) and active in the NPI registry since January 2013. He is affiliated with Mon Health Medical Center and is a graduate of Other (2012).

NPPES Registry Identity

NPI1538406871

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameJACOB ALLEN RODERICKCredential: CRNA

Location Address1200 J D ANDERSON DRMorgantown, WV 26505-3494

Mailing Address118 Chess RdSmithfield, PA 15478-1418

Phone(706) 650-0705

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJanuary 7, 2013

Last NPPES UpdateNovember 15, 2018

✔ NPI 1538406871 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 WV · 72425

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.

1200 J D ANDERSON DR, Morgantown, WV 26505

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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

Jacob Allen Roderick 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 ID2567616188

PECOS Enrollment IDI20130207000393

Medicare Billing Reassignment

Medicare enrollment records show Jacob Roderick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northstar Anesthesia Of West Virginia, PLLC

1,056 mi

Anesthesiology

6225 N STATE HIGHWAY 161 STE 200
Irving, TX 75038

Reassigned Medicare billing, West Virginia enrollment
263 clinicians in this Medicare group

NPI 1821448150 (214) 687-0001

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 5

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.

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

27 services15 patients

Anesthesia for x-ray or radiation therapy 01922

Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.

23 services21 patients

Anesthesia for heart artery bypass grafting on heart-lung machine 00567

Anesthesia for heart artery bypass grafting on a heart-lung machine involves administering medications to induce sleep and eliminate pain during surgery. The heart-lung machine takes over heart and lung functions, ensuring blood flow and oxygen supply to the body.

22 services20 patients

Insertion of artery tube for blood sampling or infusion through skin 36620

This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.

20 services19 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mon Health Medical Center

Acute Care Hospitals · Morgantown, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510024

Location1200 Jd Anderson DriveMorgantown, WV 26505 · Monongalia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26505 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.31/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

86.25

Improvement Activities

Reported Quality Measures

Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU)

Percentage of patients, regardless of age, who are under the care of an anesthesia practitioner and are admitted to a PACU or other non-ICU location in which a post-anesthetic formal transfer of care protocol or checklist which includes the key transfer of…

100%89 patients5/55-star benchmark: 100%

Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy

Percentage of patients, aged 18 years and older, who undergo a procedure under an inhalational general anesthetic, AND who have three or more risk factors for post-operative nausea and vomiting (PONV), who receive combination therapy consisting of at least…

88%33 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

FILIP IONESCU MD

Internal Medicine (Hematology & Oncology)