Individual provider Active NPI

Michael J. Cerullo, M.D.

  • Anesthesiology Physician
  • Middletown, CT
National Provider Identifier
1275553588
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
035011 Issued in CT
Practice address
80 S Main St
Middletown, CT 06457-3648
Phone
(860) 347-0720
Fax
(860) 347-0301
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 035011 CT Primary

Addresses

Primary practice location

80 S Main St
Middletown, CT 06457-3648

Mailing address

80 S Main St
Middletown, CT 06457-3648
Phone (860) 347-0720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230605000455 TN Practitioner - Anesthesiology 0648277103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New Mexico School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians

Practice addresses (Care Compare)

2000 Church St
Nashville, TN 37236-0001
Phone (615) 284-5555

5655 1St Blvd
Hermitage, TN 37076-2053
Phone (615) 316-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.57 of 100Reported as group
Quality
59.49
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035011CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group, PC Anesthesiology CurrentSince Jan 28, 2023 Accepting new patients

Locations

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

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 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275553588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "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": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-347-0720",
            "fax_number": "860-347-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERULLO",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "035011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.