Individual provider Active NPI

Craig Cesare Bonanni, M.D.

  • Anesthesiology Physician
  • East Hartford, CT
National Provider Identifier
1245216472
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
027217 Issued in CT
Practice address
99 E River Dr
5TH Floor
East Hartford, CT 06108-3288
Phone
(860) 282-4128
Fax
(860) 289-0746
NPI assigned
Dec 20, 2005
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 027217 CT Primary
Pediatric Anesthesiology Physician 207LP3000X 27217 CT

Addresses

Primary practice location

99 E River Dr
5TH Floor
East Hartford, CT 06108-3288

Mailing address

2 Trap Falls Rd
Suite 414
Shelton, CT 06484-4616
Phone (860) 282-4128

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9520

Other identifiers 1

IdentifierTypeStateIssuer
001272178MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
027217CTMDAnesthesiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1245216472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD",
            "address_2": "SUITE 414",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844616",
            "telephone_number": "860-282-4128",
            "fax_number": "860-289-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E RIVER DR",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083288",
            "telephone_number": "860-282-4128",
            "fax_number": "860-289-0746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONANNI",
        "first_name": "CRAIG",
        "middle_name": "CESARE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "027217",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CT",
            "license": "27217",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001272178",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.