Individual provider Active NPI

Matthew Ellis, CRNA

  • Certified Registered Nurse Anesthetist
  • Hartford, CT
National Provider Identifier
1366844219
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
006014 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06106-3315
Phone
(860) 972-2117
Fax
(860) 545-1784
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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 006014 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06106-3315

Mailing address

38 Hillcrest Ave
Derby, CT 06418-2213
Phone (203) 627-3515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150303000599 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204152630 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1510

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2014 Accepting new patients
Wilton Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
New England Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

4 Northwestern Dr
Bloomfield, CT 06002
Phone (860) 243-2969

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

495 Hawley Ln
Ste 2A
Stratford, CT 06614
Phone (203) 210-6333

400 10th St E
Waconia, MN 55387

Organizations & group practices 4

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 3

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1366844219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 HILLCREST AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182213",
            "telephone_number": "203-627-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063315",
            "telephone_number": "860-972-2117",
            "fax_number": "860-545-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "006014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.