Individual provider Active NPI

Mary Miller

  • Certified Registered Nurse Anesthetist
  • Willimantic, CT
National Provider Identifier
1447620703
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6781 Issued in CT
Practice address
1185 Main St Ste 4
Willimantic, CT 06226-2093
Phone
(860) 423-7556
Fax
(860) 423-4694
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 RN255546 MA
Certified Registered Nurse Anesthetist 367500000X EL11037 NH
Certified Registered Nurse Anesthetist 367500000X 6781 CT Primary

Addresses

Primary practice location

1185 Main St Ste 4
Willimantic, CT 06226-2093

Mailing address

12 Rhonda Rheault Dr # 1
Oxford, MA 01540-2300
Phone (774) 670-8566

Other practice location 1

1 General St
Lawrence, MA 01841-2997
Phone (978) 683-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA, NH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170725003397 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507136447 Reassigns benefits to 1 organization
I20190924001305 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507136447 Reassigns benefits to 3 organizations
I20230207001174 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507136447 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granite State Anesthesia Partners, LLCGroup PAC ID 6709315708, 41 clinicians
Milford Anesthesia Consultants PCGroup PAC ID 0446671333, 43 clinicians
North American Partners in Anesthesia Massachusetts LLCGroup PAC ID 8820350713, 37 clinicians

Practice addresses (Care Compare)

100 McGregor St
Manchester, NH 03102-3730
Phone (800) 437-9666

14 Prospect St
Milford, MA 01757-3003
Phone (508) 422-2343

300 C Faunce Corner Rd
Dartmouth, MA 02747-1257
Phone (508) 679-3131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.82 of 100Reported as group
Quality
70
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as apm
Quality
73.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Group PC CurrentSince Jan 10, 2023 Accepting new patients
Anesthesia Associates of Willimantic PC CurrentSince Mar 21, 2022 Accepting new patients
North American Partners in Anesthesia Massachusetts LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 21, 2021 Accepting new patients
Milford Anesthesia Consultants PC CurrentSince Jun 14, 2021 Accepting new patients
JJM Medical Services, PC CurrentSince Mar 1, 2020 Accepting new patients
Matrix Pathology and Laboratory Services PLLC Current Accepting new patients
Hospitalist Medicine Physicians of New York - Patchogue PC CurrentSince Oct 11, 2023 Accepting new patients
Granite State Anesthesia Partners, LLC CurrentSince Feb 27, 2025 Accepting new patients
Catholic Medical Center CurrentSince Sep 5, 2024 Accepting new patients

Locations

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

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

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

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

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

300D Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 998-6683

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

100 McGregor St
Ste C234
Manchester, NH 03102
Phone (603) 663-6180

10 Prospect St
Ste 101
Nashua, NH 03060
Phone (603) 578-9909

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

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

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 9

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1447620703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RHONDA RHEAULT DR # 1",
            "city": "OXFORD",
            "state": "MA",
            "postal_code": "015402300",
            "telephone_number": "774-670-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 MAIN ST STE 4",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262093",
            "telephone_number": "860-423-7556",
            "fax_number": "860-423-4694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 General St",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018412997",
            "country_code": "US",
            "telephone_number": "978-683-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN255546",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "EL11037",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "6781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.