NPIMap

Individual provider Active NPI

Jacen Knowlton, CRNA

  • Certified Registered Nurse Anesthetist
  • Shelton, CT
National Provider Identifier
1558830943
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
131798 Issued in CT
Practice address
2 Trap Falls Rd Ste 414
Shelton, CT 06484-7621
Phone
(203) 929-7353
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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 131798 CT Primary

Addresses

Primary practice location

2 Trap Falls Rd Ste 414
Shelton, CT 06484-7621

Mailing address

99 East River Drive
5TH Floor
East Hartford, CT 06108-7301
Phone (860) 282-0833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200416003596 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648515999 Reassigns benefits to 5 organizations
I20210406000704 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648515999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Anesthesia SolutionsGroup PAC ID 9234357906, 210 clinicians
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

14502 W Meeker Blvd
Sun City, AZ 85375-5282
Phone (623) 524-4000

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131798CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Anesthesia Solutions Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
District Medical Group, Inc CurrentSince Jun 19, 2024 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Hospitalist Medicine Physicians of Arizona - Nogales Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince May 15, 2023 Accepting new patients
District Medical Group, Inc CurrentSince Jun 19, 2024 Accepting new patients
Anesthesia Partners of Arizona LLC Anesthesiology CurrentSince Apr 1, 2020 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince May 15, 2023 Accepting new patients
Northstar Anesthesia, PA Anesthesiology CurrentSince Mar 19, 2021 Accepting new patients
Metro Anesthesia Consultants P C Anesthesiology Past Accepting new patients
North American Partners in Anesthesia Connecticut PC Anesthesiology Past Accepting new patients

Locations

560 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 774-3044

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 344-5287

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

7330 N 16th St
Ste A200
Phoenix, AZ 85020
Phone (602) 200-9021

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

2000 E Lamar Blvd
Ste 430
Arlington, TX 76006
Phone (239) 321-5029

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 11

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 12

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1558830943",
    "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": "061087301",
            "telephone_number": "860-282-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD STE 414",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064847621",
            "telephone_number": "203-929-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLTON",
        "first_name": "JACEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "131798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.