Individual provider Active NPI

Cynthia Mary Ronan IV, M.D.

  • Obstetrics & Gynecology Physician
  • Derby, CT
National Provider Identifier
1346251659
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33188 Issued in CT
Practice address
300 Seymour Ave
Suite 108
Derby, CT 06418-1343
Phone
(203) 736-6383
Fax
(203) 736-0499
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 033188 CT
Obstetrics & Gynecology Physician 207V00000X 33188 CT Primary

Addresses

Primary practice location

300 Seymour Ave
Suite 108
Derby, CT 06418-1343

Mailing address

300 Seymour Ave Ste 108
Derby, CT 06418-1343
Phone (203) 736-6383

Other identifiers 1

IdentifierTypeStateIssuer
001331884MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120119000471 CT Practitioner - Obstetrics/Gynecology 8123295946 Reassigns benefits to 1 organization
Practice locations: Derby, CT

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

300 Seymour Ave
Suite 102
Derby, CT 06418-1343
Phone (203) 516-5303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33188CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Faculty Physicians, Inc. CurrentSince Dec 1, 2022 Accepting new patients

Locations

300 Seymour Ave
Ste 102
Derby, CT 06418
Phone (203) 516-5303

130 Division St
Derby, CT 06418
Phone (203) 732-1330

300 Seymour Ave
Ste 108
Derby, CT 06418
Phone (203) 736-6383

Interoperability endpoints

  • Direct secure messaging: cynthia.ronan.1@1323.direct.athenahealth.com

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 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1346251659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SEYMOUR AVE STE 108",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181343",
            "telephone_number": "203-736-6383",
            "fax_number": "203-736-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SEYMOUR AVE",
            "address_2": "SUITE 108",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181343",
            "telephone_number": "203-736-6383",
            "fax_number": "203-736-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONAN",
        "first_name": "CYNTHIA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "033188",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "33188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001331884",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.