Active NPI
Craig Cesare Bonanni, M.D.
- Anesthesiology Physician
- East Hartford, CT
National Provider Identifier
1245216472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 027217
- 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, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001272178 | Medicaid | CT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 027217 | CT | MD | Anesthesiology 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.