Individual provider Active NPI

Bonnie Molloy, CRNA

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
National Provider Identifier
1316971336
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
000483 Issued in CT
Practice address
267 Grant St
Bridgeport Anesthesia Associates, P.C.
Bridgeport, CT 06610-2805
Phone
(203) 384-3072
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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 000483 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport Anesthesia Associates, P.C.
Bridgeport, CT 06610-2805

Mailing address

7365 Main St
Suite 310
Stratford, CT 06614-1300
Phone (203) 384-3174

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000867 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800063942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000483CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2000 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

7365 Main St
Ste 310
Stratford, CT 06614
Phone (203) 384-3174

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1316971336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "address_2": "SUITE 310",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300",
            "telephone_number": "203-384-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "address_2": "BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "BONNIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "000483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.