Individual provider Active NPI

Laurie-Ann Nessralla, M.D.

  • Anesthesiology Physician
  • Bridgeport, CT
National Provider Identifier
1417902370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
36642 Issued in CT
Practice address
267 Grant St
Bridgeport Hospital
Bridgeport, CT 06610-2805
Phone
(203) 384-3072
NPI assigned
May 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36642 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport Hospital
Bridgeport, CT 06610-2805

Mailing address

7365 Main St
Suite 310
Stratford, CT 06614-1300

Other identifiers 4

IdentifierTypeStateIssuer
1366427MedicaidCT
36642OtherCTCONNECTICARE
5748143OtherCTAETNA CT
500HBA011CT01OtherCTBCBS CT

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
I20050613001135 CT Practitioner - Anesthesiology 8022052836 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36642CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Anesthesia Associates, P.C. Anesthesiology CurrentSince Apr 1, 2005 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

7365 Main St
Ste 310
Stratford, CT 06614
Phone (203) 384-3174

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417902370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "address_2": "SUITE 310",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "address_2": "BRIDGEPORT HOSPITAL",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESSRALLA",
        "first_name": "LAURIE-ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "36642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366427",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "36642",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CT",
            "identifier": "5748143",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CT",
            "identifier": "500HBA011CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.