| Jessica Marie Laslovich, | |
|
200 High Park Ave, Goshen, IN 46526-4810 | |
| (317) 340-8384 | |
| Not Available |
| Full Name | Jessica Marie Laslovich |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 4 Years |
| Location | 200 High Park Ave, Goshen, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508515396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 28248221A (Indiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 281848927 (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Loma Linda University Medical Center | Loma linda, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Faculty Physicians And Surgeons Of Llusm | 1153227814 | 1153 |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Entity Name | Amsurg South Bay Anesthesia Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811230022 PECOS PAC ID: 4082853411 Enrollment ID: O20130617000101 |
| Entity Name | La Jolla Anesthesia Associates, Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649717737 PECOS PAC ID: 3678850567 Enrollment ID: O20170502001302 |
| Entity Name | Amsurg Clovis Ca Anesthesia Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710731773 PECOS PAC ID: 4082146741 Enrollment ID: O20241018002060 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Marie Laslovich, 11217 Candice Dr, Fishers, IN 46038-5555 Ph: () - | Jessica Marie Laslovich, 200 High Park Ave, Goshen, IN 46526-4810 Ph: (317) 340-8384 |
Derek S Poulson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 57809 Hillside Dr, Goshen, IN 46528 Phone: 801-623-7813 | |
Janice Moore, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 317-340-8384 | |
Brett Dyer, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 20208 Deer Path Ct., Goshen, IN 46528 Phone: 801-864-0218 |