Individual provider Active NPI

Michael Henry Wilhelm, CRNA

  • Certified Registered Nurse Anesthetist
  • Hartford, CT
National Provider Identifier
1396096921
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5250 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06106-3300
Phone
(860) 545-5000
NPI assigned
Sep 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 91681 CT
Registered Nurse 163W00000X 598579 NY
Certified Registered Nurse Anesthetist 367500000X 5250 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06106-3300

Mailing address

99 East River Drive
5TH Floor
East Hartford, CT 06108
Phone (347) 739-6947

Other practice location 1

675 Townsend Ave
Unit 104
New Haven, CT 06512-3101
Phone (347) 739-6947

Other practice location 2

263 Farmington Ave
Farmington, CT 06032-1956
Phone (860) 679-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilhelm10448@direct.med.uchc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130417000039 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749332328 Reassigns benefits to 2 organizations
I20171207000214 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749332328

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
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)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91681CTMDRegistered Nurse
598579NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2014 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Jul 13, 2020 Accepting new patients
Resource Anesthesiology Associates of CT PC Nurse Anesthetist, Certified Registered CurrentSince Jul 19, 2021 Accepting new patients

Locations

263 Farmington Ave
#6305
Farmington, CT 06032

263 Farmington Ave
Farmington, CT 06032
Phone (860) 679-1706

99 E River Dr
Fl 5
Hartford, CT 06108
Phone (860) 282-4022

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

505 Willard Ave
Newington, CT 06111
Phone (860) 224-6709

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (860) 282-4128

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

539 Danbury Rd
Wilton, CT 06897
Phone (203) 834-7700

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Organizations & group practices 3

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 2

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": "1348272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1396096921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DRIVE",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "347-739-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063300",
            "telephone_number": "860-545-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Townsend Ave",
            "address_2": "Unit 104",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065123101",
            "country_code": "US",
            "telephone_number": "347-739-6947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-22",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "91681",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "598579",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "5250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilhelm10448@direct.med.uchc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060321956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 16, 2021; 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.