Individual provider Active NPI

Brandon Soley

  • Certified Registered Nurse Anesthetist
  • Bristol, CT
National Provider Identifier
1104617620
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14873 Issued in CT
Practice address
41 Brewster Rd
Bristol, CT 06010-5161
Phone
(860) 585-3000
NPI assigned
May 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 134632 CT
Certified Registered Nurse Anesthetist 367500000X 14873 CT Primary

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06010-5161

Mailing address

41 Brewster Rd
Bristol, CT 06010-5141
Phone (860) 585-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825004198 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759881584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland Anesthesia Associates PCGroup PAC ID 8820083652, 172 clinicians
Charter Anesthesiology LLCGroup PAC ID 2163763830, 34 clinicians

Practice addresses (Care Compare)

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

41 Brewster Rd
Bristol, CT 06010-5161
Phone (800) 585-3000

Hospital & facility affiliations

  • Bristol Hospital Hospital, Bristol, CT, CCN 070029
  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14873CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Anesthesiology LLC CurrentSince Jun 19, 2025 Accepting new patients
Woodland Anesthesia Associates PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

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

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

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

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 4

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": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1104617620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105141",
            "telephone_number": "860-585-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105161",
            "telephone_number": "860-585-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLEY",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "134632",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "14873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.