Individual provider Active NPI

Cynthia Hall McCraven, MD

  • Obstetrics & Gynecology Physician
  • Wallingford, CT
National Provider Identifier
1457425100
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
030434 Issued in CT
Practice address
863 N Main Street Ext Ste 301
Wallingford, CT 06492-2434
Phone
(203) 269-0885
NPI assigned
Nov 17, 2006
Last updated
Oct 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 030434 CT Primary

Addresses

Primary practice location

863 N Main Street Ext Ste 301
Wallingford, CT 06492-2434

Mailing address

863 N Main Street Ext Ste 301
Wallingford, CT 06492-2434
Phone (203) 269-0885

Other identifiers 6

IdentifierTypeStateIssuer
P1024514OtherCTOXFORD
4124033OtherCTAETNA
0V0941OtherCTHEALTHNET
98525OtherCTCIGNA
010030434CT01OtherCTBLUE SHIELD
304340OtherCTCONNECTICARE

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
I20090501000446 CT Practitioner - Obstetrics/Gynecology 8325196272 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030434CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women's Health LLC Obstetrics & Gynecology CurrentSince Feb 2, 2010 Accepting new patients

Locations

22 Waterville Rd
Avon, CT 06001
Phone (860) 678-3461

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

435 Lewis Ave
Ste 212
Meriden, CT 06451
Phone (203) 238-0519

98 Main St
Ste 301
Southington, CT 06489
Phone (860) 621-6704

863 N Main Street Ext
Ste 301
Wallingford, CT 06492
Phone (203) 269-0885

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Hospital of Central ConnecticutNew Britain, CT, CCN 070035 Hospital Corporate Director Jun 23, 2020
The Hospital of Central ConnecticutNew Britain, CT, CCN 07S035 Hospital Corporate Director Jul 23, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1457425100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT STE 301",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-269-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT STE 301",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-269-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAVEN",
        "first_name": "CYNTHIA",
        "middle_name": "HALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "030434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1024514",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4124033",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V0941",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "98525",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "010030434CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "304340",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.