Individual provider Active NPI

Rozlyn Grace Poray, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1366912701
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7982 Issued in CT
Practice address
1450 Chapel St
New Haven, CT 06511-4440
Phone
(203) 416-9032
NPI assigned
Nov 28, 2018
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 31389 TN
Certified Registered Nurse Anesthetist 367500000X 7982 CT Primary
Registered Nurse 163W00000X 138969 CT

Addresses

Primary practice location

1450 Chapel St
New Haven, CT 06511-4440

Mailing address

4753 Mallard Lake CV
Collierville, TN 38017-9360
Phone (207) 416-9032

Other practice location 1

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-9666

Other practice location 2

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 448-5893

Other names 1

  • Rozlyn Grace Petersen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NH, ME, TN4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20190128001964 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345587424 Reassigns benefits to 2 organizations
I20200521001362 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345587424 Reassigns benefits to 1 organization
I20200522000099 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345587424 Reassigns benefits to 3 organizations
I20220607002497 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345587424 Reassigns benefits to 5 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
Lifelinc Anesthesia II, PLLCGroup PAC ID 2668658493, 39 clinicians
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians
Portsmouth Anesthesia Associates PAGroup PAC ID 6002855327, 40 clinicians
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

100 Northcrest Dr
Springfield, TN 37172-3927
Phone (901) 844-1590

2986 Kate Bond Rd
Bartlett, TN 38133-4003
Phone (901) 820-7000

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

435 2ND St
Newport, TN 37821-3703
Phone (423) 625-2200

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-8336

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138969CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Dec 16, 2019 Accepting new patients
Ut Regional One Physicians Inc Anesthesiology Current Accepting new patients
Bridgton Hospital CurrentSince Jun 21, 2025 Accepting new patients
Yale University Anesthesiology CurrentSince Dec 4, 2018 Accepting new patients
Rumford Hospital CurrentSince Jun 21, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince May 15, 2022 Accepting new patients
Ut Regional One Physicians Inc Anesthesiology CurrentSince Oct 17, 2024 Accepting new patients
Woodland Anesthesia Associates PC Anesthesiology CurrentSince Dec 23, 2018 Accepting new patients
Bridgton Hospital CurrentSince Jun 21, 2025 Accepting new patients
Yale University CurrentSince Dec 4, 2018 Accepting new patients
Portsmouth Anesthesia Associates PA Anesthesiology CurrentSince Apr 19, 2020 Accepting new patients
East Memphis Anesthesia Services PLC Anesthesiology CurrentSince May 28, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. Anesthesiology CurrentSince May 15, 2022 Accepting new patients
Lifelinc Anesthesia VIII PLLC Anesthesiology CurrentSince Oct 23, 2024 Accepting new patients
Central Maine Medical Center CurrentSince Dec 16, 2019 Accepting new patients
Lifelinc Anesthesia II, PLLC Anesthesiology CurrentSince Jun 8, 2023 Accepting new patients
Rumford Hospital CurrentSince Jun 21, 2025 Accepting new patients
East Memphis Anesthesia Services, PLLC Past Accepting new patients

Locations

701 Cottage Grove Rd
Ste F230
Bloomfield, CT 06002
Phone (860) 243-5569

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

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

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

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

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

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": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1366912701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 MALLARD LAKE CV",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179360",
            "telephone_number": "207-416-9032"
        },
        {
            "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": "065114440",
            "telephone_number": "203-416-9032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051208",
            "country_code": "US",
            "telephone_number": "860-714-9666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "877 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032807",
            "country_code": "US",
            "telephone_number": "901-448-5893",
            "fax_number": "901-448-5540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORAY",
        "first_name": "ROZLYN",
        "middle_name": "GRACE",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "31389",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "7982",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "138969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROZLYN",
            "last_name": "PETERSEN",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 17, 2024; 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.