Individual provider Active NPI

Carolyn Alcordo Connelly, CRNA

  • Certified Registered Nurse Anesthetist
  • Washington, DC
National Provider Identifier
1124098454
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024167454 Issued in VA
Practice address
3800 Reservoir Rd NW
CCC Building, Lower Level
Washington, DC 20007-2113
Phone
(202) 444-6680
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN966526 DC
Certified Registered Nurse Anesthetist 367500000X 517664 NY
Certified Registered Nurse Anesthetist 367500000X 0024167454 VA Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
CCC Building, Lower Level
Washington, DC 20007-2113

Mailing address

PO Box 418283
Boston, MA 02241-8283
Phone (703) 558-1544

Other identifiers 1

IdentifierTypeStateIssuer
P00706928OtherDCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081016000037 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678507415 Reassigns benefits to 8 organizations
I20210915003924 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678507415 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ambulatory Anesthesia Services IncGroup PAC ID 3274516042, 18 clinicians

Practice addresses (Care Compare)

10730 Main St
Fairfax, VA 22030-3704
Phone (703) 691-0670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
517664NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Cares - Community CurrentSince Jun 12, 2023 Accepting new patients
Dominion Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Capital Anesthesia Partners, LLC CurrentSince Feb 26, 2021 Accepting new patients
Ambulatory Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Aug 1, 2021 Accepting new patients
Surgical Anesthesia Associates, PLLC CurrentSince Aug 20, 2019 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Aug 1, 2024 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Aug 1, 2021 Accepting new patients
Medstar Georgetown Medical Center, Inc PastSince Aug 20, 2019 Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

2021 K St NW
Ste T120
Washington, DC 20006
Phone (202) 775-0574

6355 Walker Ln
Ste 200
Alexandria, VA 22310
Phone (703) 922-9501

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

2710 Prosperity Ave
Ste 200
Fairfax, VA 22031
Phone (703) 650-2333

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

Organizations & group practices 10

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1124098454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418283",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418283",
            "telephone_number": "703-558-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "CCC BUILDING, LOWER LEVEL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "CAROLYN",
        "middle_name": "ALCORDO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DC",
            "license": "RN966526",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "517664",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024167454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00706928",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.