Individual provider Active NPI

Emily Alyce Sheridan, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1326526609
Registry record updated Sep 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2281304 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-3030
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 2281304 MA
Certified Registered Nurse Anesthetist 367500000X RN2281304 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

12 Border St
Quincy, MA 02171-1013
Phone (603) 494-1009

Other practice location 1

12 Border St
Quincy, MA 02171-0217
Phone (603) 494-1009

Other practice location 2

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201125001280 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597176487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2281304MAMDCritical Care Medicine Registered Nurse
RN2281304MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 31, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 31, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

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.

Hospital & facility affiliations 1

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599955200000",
    "number": "1326526609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BORDER ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021711013",
            "telephone_number": "603-494-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Border St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021710217",
            "country_code": "US",
            "telephone_number": "603-494-1009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "EMILY",
        "middle_name": "ALYCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-09-13",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "2281304",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2281304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2020; 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.