Individual provider Active NPI

Carol Buckley, CRNA

  • Certified Registered Nurse Anesthetist
  • Hartford, CT
National Provider Identifier
1154722957
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
82541 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06106-3315
Phone
(860) 972-3117
Fax
(860) 545-1784
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 82541 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06106-3315

Mailing address

99 E River Dr
5TH Floor
East Hartford, CT 06108-3288
Phone (860) 282-4133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150326001643 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385961523 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
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)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 282-0833

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82541CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 9, 2015 Accepting new patients
Anesthesiologists of Middletown, P.C. CurrentSince Feb 1, 2015 Accepting new patients

Locations

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

99 E River Dr
Fl 5
Hartford, CT 06108
Phone (860) 282-4022

145 S Main St
Middletown, CT 06457
Phone (860) 346-5889

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

410 Saybrook Rd
Middletown, CT 06457
Phone (615) 686-2262

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (860) 282-4128

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

Interoperability endpoints

  • Direct secure messaging: carol.buckley@xdr.hhchealthdirect.org

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 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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1154722957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E RIVER DR",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083288",
            "telephone_number": "860-282-4133",
            "fax_number": "860-289-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063315",
            "telephone_number": "860-972-3117",
            "fax_number": "860-545-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "CAROL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "82541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.