Individual provider Active NPI

Maryori Carmona, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1053642801
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2263862 Issued in MA
Practice address
1 Boston Medical Ctr PL Dept of
Department of Anesthesia
Boston, MA 02118-2908
Phone
(617) 638-6950
Fax
(617) 638-6966
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 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 RN2263862 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL Dept of
Department of Anesthesia
Boston, MA 02118-2908

Mailing address

801 Albany St
FL G
Boston, MA 02119
Phone (617) 414-5405

Other identifiers 1

IdentifierTypeStateIssuer
110125123AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100312000214 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042345316 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Anesthesia PCGroup PAC ID 9638255300, 33 clinicians
Cape Cod Anesthesia Associates, IncGroup PAC ID 0749260933, 39 clinicians

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

27 Park St
Hyannis, MA 02601-5230
Phone (508) 771-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2263862MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Anesthesia, P.C. CurrentSince Apr 8, 2024 Accepting new patients
Cape Cod Anesthesia Associates, Inc. CurrentSince Sep 1, 2020 Accepting new patients
On Demand Anesthesia LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

700 Attucks Ln
Unit 1B
Hyannis, MA 02601
Phone (508) 367-3557

100 Morse St
Norwood, MA 02062
Phone (781) 255-0362

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

Organizations & group practices 3

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 2

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": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1053642801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST",
            "address_2": "FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02119",
            "telephone_number": "617-414-5405",
            "fax_number": "617-414-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL DEPT OF",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-638-6950",
            "fax_number": "617-638-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "MARYORI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2263862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110125123A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.