Individual provider Active NPI

Jessie Marcoulier-Gladu, CRNA

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1316412927
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7991 Issued in CT
Practice address
1450 Chapel St
New Haven, CT 06511-4405
Phone
(203) 789-3000
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 7991 CT Primary

Addresses

Primary practice location

1450 Chapel St
New Haven, CT 06511-4405

Mailing address

690 N Colony St Unit 13
Meriden, CT 06450-2358
Phone (413) 297-6918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190103001224 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022353515 Reassigns benefits to 1 organization
I20200206001045 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022353515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-9338

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Franklin Medical Center Hospital, Greenfield, MA, CCN 220016
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
7991CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Anesthesia Service, Inc. CurrentSince Dec 11, 2019 Accepting new patients
Baystate Medical Practices, Inc CurrentSince Jan 1, 2025 Accepting new patients
Yale University CurrentSince Nov 29, 2018 Accepting new patients
Yale University CurrentSince Nov 29, 2018 Accepting new patients
Umass Memorial Medical Group Inc Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

908 Allen St
Springfield, MA 01118
Phone (413) 732-5139

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

Organizations & group practices 5

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 5

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1316412927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 N COLONY ST UNIT 13",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064502358",
            "telephone_number": "413-297-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOULIER-GLADU",
        "first_name": "JESSIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "7991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.