Adam Ryan-Lewis Boucher, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Danbury, CT
NPI 1013429158 · NPPES record last updated Nov 16, 2019
Key facts
- NPI
- 1013429158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 7352 (CT)
- Practice address
- 24 Hospital Ave
Danbury, CT 06810-6099 - Phone
- (860) 377-4177
- NPI assigned
- Oct 30, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Yale University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Synergy Anesthesia CT PLLC
Practice addresses (Care Compare)
64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-7280
Hospital & facility affiliations
- Waterbury Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180118002052 | CT | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8022377159 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7352 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Nuvance Health Medical Practice CT, Inc. | Current |
Accepting new patients | |
| Synergy Anesthesia CT PLLC | Current |
Accepting new patients | |
| Anesthesiologists of Middletown, P.C. | Past |
Accepting new patients |
Locations
24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118
73 Sand Pit Rd
Danbury, CT 06810
Phone (203) 743-2400
80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249
28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000
21 Elm St
New Milford, CT 06776
Phone (860) 210-5000
2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375
64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 7352 | CT | Yes |
Addresses
Primary practice location
24 Hospital Ave
Danbury, CT 06810-6099
Mailing address
23 Huntingtown Rd
Newtown, CT 06470-2626
Phone (860) 377-4177
Other practice location 1
21 Elm St
New Milford, CT 06776-2915
Phone (860) 377-4177
Other providers in Danbury, CT
- Jessica Bosavage
- Amelia S Botelho
- Kristin Ann Bott
- Thomas Botta
- Bradford A Bottger
- Melissa Bourdeau
- Diane Kay Bowler
- Jillian Bowler
- Monique Bowman
- Jennifer Boyce
All providers in Danbury, CT · Certified Registered Nurse Anesthetist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.