Individual provider Active NPI

Kristen Martinez

  • Certified Registered Nurse Anesthetist
  • Middletown, CT
National Provider Identifier
1215274733
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
079542 Issued in CT
Practice address
51 S Main St
Middletown, CT 06457-3606
Phone
(860) 347-0720
Fax
(860) 347-0301
NPI assigned
Jan 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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 079542 CT Primary

Addresses

Primary practice location

51 S Main St
Middletown, CT 06457-3606

Mailing address

51 S Main St
Middletown, CT 06457-3606
Phone (860) 347-0720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000218 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911143326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiologists of Middletown, P.C.Group PAC ID 2769479781, 34 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 347-0720

410 Saybrook Rd
Middletown, CT 06457-4777
Phone (860) 347-0720

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079542CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Middletown, P.C. CurrentSince Jan 9, 2013 Accepting new patients

Locations

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

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

51 S Main St
Middletown, CT 06457
Phone (860) 344-0055

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

Organizations & group practices 1

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 1

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": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1215274733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573606",
            "telephone_number": "860-347-0720",
            "fax_number": "860-347-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573606",
            "telephone_number": "860-347-0720",
            "fax_number": "860-347-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "079542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.