Individual provider Active NPI

Brandon Dube, CRNA

  • Certified Registered Nurse Anesthetist
  • Hartford, CT
National Provider Identifier
1033732094
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
147377 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06102-8000
Phone
(860) 545-5000
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 147377 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06102-8000

Mailing address

99 East River Drive
5TH Floor
East Hartford, CT 06108
Phone (860) 282-0833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200902000877 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113344359 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

164 High St
Greenfield, MA 01301-2613
Phone (413) 794-2273

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

40 Wright St
Palmer, MA 01069-1138
Phone (413) 370-5356

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
8913CTMDProfessional Counselor
147377CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital Current Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Dec 1, 2022 Accepting new patients
Springfield Anesthesia Service, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Baystate Medical Practices, Inc CurrentSince Jan 1, 2025 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Dec 1, 2022 Accepting new patients
North American Partners in Anesthesia Connecticut PC Past Accepting new patients
Umass Memorial Medical Group Inc Past Accepting new patients

Locations

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Springfield, MA 01199
Phone (413) 794-3909

516 Carew St
Springfield, MA 01104
Phone (413) 787-2000

908 Allen St
Springfield, MA 01118
Phone (413) 732-5139

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1033732094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DRIVE",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "860-282-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-545-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "BRANDON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "147377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.