Individual Healthcare Provider
Kyungmoon Roh, CRNA
Provider's NPPES record last updated: September 28, 2024
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1245986140
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Practice Location
- Hackensack, New Jersey
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 1:45 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Anesthetist, Certified Registered
Physician Assistants & Advanced Practice Nursing Providers
(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.
Taxonomy code 367500000X
Provider-Reported License Information
- Nurse Anesthetist, Certified Registered (New York)
- 680524
- Nurse Anesthetist, Certified Registered (New Jersey)
- 26NJ01262000
Practice Locations
Practice Location
30 Prospect Ave
Hackensack, New Jersey 07601-1915
Phone: (551) 996-2419
Additional Practice Location
5645 Main St
Flushing, New York 11355-5045
Phone: (718) 670-2000
Record Information
- Enumeration Date
- March 1, 2022
- Provider's NPPES Record Last Updated
- September 28, 2024
- Certification Date
- September 28, 2024
- NPISignal NPPES Dataset
- August 2026
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