NPIMap

Organization Active NPI

Anesthesia Associates of Willimantic PC

  • Anesthesiology Physician
  • Willimantic, CT
National Provider Identifier
1306905799
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
029636 Issued in CT
Legal business name
ANESTHESIA ASSOCIATES OF WILLIMANTIC PC
Practice address
1185 Main St
Suite 2
Willimantic, CT 06226-2093
Phone
(860) 423-7558
Fax
(860) 423-4694
NPI assigned
Dec 8, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Robert Adam, MDNPI 1427161827
Title
Anesthesiologist
Phone
(860) 423-7558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 029636 CT Primary

Addresses

Primary practice location

1185 Main St
Suite 2
Willimantic, CT 06226-2093

Mailing address

1185 Main St
Suite 2
Willimantic, CT 06226-2093
Phone (860) 423-7558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080227000090 CT Part B Supplier - Clinic/Group Practice 2163506353 Receives reassigned benefits from 92 practitioners
Practice locations: Willimantic, CT; Putnam, CT; Norwich, CT

National Provider Directory

National Provider Directory

Locations

37 Kennedy Dr
Ste C
Putnam, CT 06260
Phone (860) 423-7558

1185 Main St
Willimantic, CT 06226
Phone (860) 423-7558

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1306905799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 MAIN ST",
            "address_2": "SUITE 2",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262093",
            "telephone_number": "860-423-7558",
            "fax_number": "860-423-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 MAIN ST",
            "address_2": "SUITE 2",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262093",
            "telephone_number": "860-423-7558",
            "fax_number": "860-423-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA ASSOCIATES OF WILLIMANTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "860-423-7558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "029636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.