Individual provider Active NPI

Rebecca Anne Kiss

  • Certified Registered Nurse Anesthetist
  • Shelton, CT
National Provider Identifier
1114718491
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
149105 Issued in CT
Practice address
2 Corporate Dr Ste 9559TH
Shelton, CT 06484-6238
Phone
(860) 929-7353
NPI assigned
May 15, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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 149105 CT Primary

Addresses

Primary practice location

2 Corporate Dr Ste 9559TH
Shelton, CT 06484-6238

Mailing address

40 Deborah Dr
Coventry, CT 06238-1323
Phone (860) 539-5154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023002261 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901394626 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
Connecticut Gi PLLCGroup PAC ID 9830110758, 243 clinicians
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

300 Western Blvd
Glastonbury, CT 06033-4305
Phone (860) 657-1920

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

Hospital & facility affiliations

  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149105CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC CurrentSince Jan 6, 2026 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2025 Accepting new patients

Locations

300 Western Blvd
Glastonbury, CT 06033
Phone (860) 547-0306

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

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

2 Corporate Dr
Ste 9559TH
Shelton, CT 06484
Phone (860) 929-7353

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

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": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1114718491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DEBORAH DR",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062381323",
            "telephone_number": "860-539-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORPORATE DR STE 9559TH",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846238",
            "telephone_number": "860-929-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "149105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

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