Individual provider Active NPI

Richard Lawrence Kuntz, M.D.

  • Anesthesiology Physician
  • East Hartford, CT
National Provider Identifier
1255324604
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
035971 Issued in CT
Practice address
111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone
(860) 282-4137
Fax
(860) 282-0170
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 035971 CT Primary

Addresses

Primary practice location

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212

Mailing address

PO Box 724195
Atlanta, GA 31139-1195
Phone (860) 282-4137

Other identifiers 1

IdentifierTypeStateIssuer
001359711MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160902001460 GA Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 9638263106 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035971CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Perimeter Anesthesia LLC Anesthesiology CurrentSince Sep 1, 2019 Accepting new patients
Mak Anesthesia Holdings LLC Anesthesiology CurrentSince May 27, 2019 Accepting new patients

Locations

3005 Royal Blvd S
Ste 200
Alpharetta, GA 30022
Phone (770) 680-2335

3330 Preston Ridge Rd
Ste 200
Alpharetta, GA 30005
Phone (404) 255-1000

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

10692 Medlock Bridge Rd
Ste 100A
Johns Creek, GA 30097
Phone (404) 446-2492

100 Three Rivers Dr NE
Rome, GA 30161
Phone (706) 292-0040

5669 Peachtree Dunwoody Rd
Ste 290
Sandy Springs, GA 30342
Phone (678) 399-2050

1100 Johnson Fy Rd NE
Ste 200
Sandy Springs, GA 30342
Phone (404) 257-1900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1255324604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 724195",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311391195",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "RICHARD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "035971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001359711",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.