Individual provider Active NPI

Diane Larese, CRNA

  • Certified Registered Nurse Anesthetist
  • Hartford, CT
National Provider Identifier
1396147633
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6006 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06106-3315
Phone
(860) 972-2117
Fax
(860) 545-1784
NPI assigned
Sep 18, 2014
Last updated
Sep 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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 6006 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06106-3315

Mailing address

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

Other names 1

  • Diane Pacini Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150210001338 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941525117 Reassigns benefits to 2 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
Anesthesia Associates of Willimantic, PCGroup PAC ID 2163506353, 46 clinicians
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

1185 Main St
Willimantic, CT 06226-2093
Phone (860) 423-7558

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
6006CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Willimantic PC CurrentSince Jul 28, 2021 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 23, 2014 Accepting new patients

Locations

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

37 Kennedy Dr
Ste C
Putnam, CT 06260
Phone (860) 423-7558

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

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

1185 Main St
Willimantic, CT 06226
Phone (860) 423-7558

1185 Main St
Ste 4
Willimantic, CT 06226
Phone (860) 423-7556

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1396147633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "LARESE",
        "first_name": "DIANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "6006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "PACINI",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 18, 2017; 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.