Individual provider Active NPI

Elizabeth A Anderson, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • East Hartford, CT
National Provider Identifier
1093782526
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
002649 Issued in CT
Practice address
111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone
(860) 282-4137
Fax
(860) 282-0170
NPI assigned
Mar 3, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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 002649 CT Primary

Addresses

Primary practice location

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212

Mailing address

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone (860) 282-4137

Other identifiers 1

IdentifierTypeStateIssuer
004221727MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000002 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698955607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002649CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Anesthesia Associates PC CurrentSince Oct 17, 2013 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2014 Accepting new patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

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

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

505 Willard Ave
Newington, CT 06111
Phone (860) 224-6709

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (203) 929-3537

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1093782526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "002649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004221727",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.