Individual provider Active NPI

Peta-Gaye Simms, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairfield, CT
National Provider Identifier
1104499094
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
149052 Issued in CT
Practice address
1073 N Benson Rd
Fairfield, CT 06824-5171
Phone
(347) 571-3579
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 178848 CT
Certified Registered Nurse Anesthetist 367500000X 149052 CT Primary

Addresses

Primary practice location

1073 N Benson Rd
Fairfield, CT 06824-5171

Mailing address

900 Mix Ave Apt 16
Hamden, CT 06514-5106
Phone (347) 571-3579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021000419 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820520430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

5520 Park Ave
Trumbull, CT 06611-3463
Phone (203) 785-4081

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178848CTMDCritical Care Medicine Registered Nurse
149052CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Sep 5, 2024 Accepting new patients
Yale University CurrentSince Sep 5, 2024 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Organizations & group practices 2

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1104499094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MIX AVE APT 16",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065145106",
            "telephone_number": "347-571-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 N BENSON RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245171",
            "telephone_number": "347-571-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "PETA-GAYE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CT",
            "license": "178848",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "149052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.