Victor Eanniello II, MD
Individual provider Active NPI Anesthesiology Physician · Stafford Springs, CT
NPI 1174577688 · NPPES record last updated Oct 18, 2011
Key facts
- NPI
- 1174577688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 31823 (CT)
- Practice address
- 201 Chestnut Hill Rd
Stafford Springs, CT 06076-9925 - Phone
- (860) 684-8424
- Fax
- (860) 684-8460
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Woodland Anesthesia Associates PC
Integrated Anesthesia Associates LLC
Practice addresses (Care Compare)
114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-6654
80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117
Hospital & facility affiliations
- Hartford Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101101000848 | CT | Practitioner - Anesthesiology | 2860481264 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031823 | CT | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Anesthesia Associates LLC | Anesthesiology | Current |
Accepting new patients |
| Woodland Anesthesia Associates PC | Anesthesiology | Current |
Accepting new patients |
| Somers Anesthesiology Associates, LLC | Anesthesiology | Past | Accepting new patients |
Locations
701 Cottage Grove Rd
Ste F230
Bloomfield, CT 06002
Phone (860) 243-5569
114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001
80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249
300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000
2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375
201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521
Interoperability endpoints
- veanniello2388582@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 031823 | CT | |
| Anesthesiology Physician | 207L00000X | 31823 | CT | Yes |
Addresses
Primary practice location
201 Chestnut Hill Rd
Stafford Springs, CT 06076-9925
Mailing address
99 East River Drive
East Hartford, CT 06108
Phone (860) 684-8424
Other providers in Stafford Springs, CT
- Michelle Marie Cunha
- Peter Cuniowski
- David E. Palozej Eyecare Associates, LLC
- Srianee M Dias
- Herbert Joseph Dimeola
- Echn Johnson Evergreen Corporation
- Echn Johnson Memorial Hospital, Inc.
- Echn Johnson Memorial Hospital, Inc.
- Deborah Eddinger
- Laura Namata Ekatan
All providers in Stafford Springs, CT · Anesthesiology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.