Individual provider Active NPI

Stacey F Hauben

  • Certified Registered Nurse Anesthetist
  • Weymouth, MA
National Provider Identifier
1558934323
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10974 Issued in CT
Practice address
55 Fogg Rd
Weymouth, MA 02190-2432
Phone
(781) 624-8000
NPI assigned
Jul 20, 2021
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 111869 CT
Certified Registered Nurse Anesthetist 367500000X 10974 CT Primary

Addresses

Primary practice location

55 Fogg Rd
Weymouth, MA 02190-2432

Mailing address

19 Rock Hill Rd
Woodbridge, CT 06525-1103
Phone (203) 927-3362

Other practice location 1

267 Grant St
Bridgeport, CT 06610-2870
Phone (203) 384-3000

Other practice location 2

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

Other practice location 3

2 Pond Park Rd
Hingham, MA 02043-4347
Phone (781) 624-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221108002694 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395112106 Reassigns benefits to 2 organizations
I20240711003467 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395112106 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111869CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 10, 2024 Accepting new patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2024 Accepting new patients
Yale University CurrentSince Sep 30, 2022 Accepting new patients
North American Partners in Anesthesia Connecticut PC CurrentSince Aug 25, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 18, 2024 Accepting new patients
Yale University CurrentSince Sep 30, 2022 Accepting new patients
South Shore Medical Center, Inc. CurrentSince Nov 21, 2024 Accepting new patients
Coastal Medical Associates Nurse Anesthetist, Certified Registered CurrentSince Nov 21, 2024 Accepting new patients

Locations

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

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

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

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

75 Francis St
Boston, MA 02115

62 13th St
Charlestown, MA 02129
Phone (617) 724-3874

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

2 Pond Park Rd
Hingham, MA 02043
Phone (781) 337-5555

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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

Hospital & facility affiliations 4

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1558934323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ROCK HILL RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251103",
            "telephone_number": "203-927-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066102870",
            "country_code": "US",
            "telephone_number": "203-384-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062601836",
            "country_code": "US",
            "telephone_number": "860-928-6541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Pond Park Rd",
            "address_purpose": "LOCATION",
            "city": "Hingham",
            "state": "MA",
            "postal_code": "020434347",
            "country_code": "US",
            "telephone_number": "781-624-8352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUBEN",
        "first_name": "STACEY",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "111869",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "10974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.