Individual provider Active NPI

Monika Pomykala, CRNA

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
National Provider Identifier
1083138127
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
12.007092 Issued in CT
Practice address
267 Grant St
Bridgeport, CT 06610-2805
Phone
(203) 367-3174
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 12.007092 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport, CT 06610-2805

Mailing address

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 367-3174

Other identifiers 1

IdentifierTypeStateIssuer
12.007092OtherCTCT APN LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925000708 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618241019 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland Anesthesia Associates PCGroup PAC ID 8820083652, 172 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-6654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12.007092CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Middletown, P.C. CurrentSince Nov 14, 2020 Accepting new patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered CurrentSince Aug 27, 2017 Accepting new patients
Woodland Anesthesia Associates PC CurrentSince Sep 4, 2017 Accepting new patients

Locations

701 Cottage Grove Rd
Ste F230
Bloomfield, CT 06002
Phone (860) 243-5569

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

145 S Main St
Middletown, CT 06457
Phone (860) 346-5889

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

410 Saybrook Rd
Middletown, CT 06457
Phone (615) 686-2262

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

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.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083138127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-367-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-367-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMYKALA",
        "first_name": "MONIKA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "12.007092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT APN LICENSE",
            "identifier": "12.007092",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.