Danielle Provoncha, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

6012 Issued in CT

Practice address

365 Montauk Ave
New London, CT 06320-4700

Phone

(860) 442-0711

Fax

(781) 407-0998

NPI assigned

Nov 10, 2014

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Yale University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charter Anesthesiology LLCGroup PAC ID 2163763830, 34 clinicians

Connecticut Gi PLLCGroup PAC ID 9830110758, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Charter Anesthesiology LLC

  • Anesthesiology Physician
  • West Hartford, CT
  • NPI 1730674532
  Medicare reassignment Care Compare group NPD
• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625
  Medicare reassignment Care Compare group NPD
• Anesthesia Associates of Willimantic PC

  • Anesthesiology Physician
  • Willimantic, CT
  • NPI 1306905799
  Medicare reassignment NPD
• Integrated Anesthesia Associates LLC

  • Anesthesiology Physician
  • Shelton, CT
  • NPI 1881636397

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• New England Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Guilford, CT
  • NPI 1891388146

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• River Valley ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Norwich, CT
  • NPI 1821332370
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1619373248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711",
            "fax_number": "781-407-0998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Salem Turnpike",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "06360",
            "country_code": "US",
            "telephone_number": "860-859-9948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVONCHA",
        "first_name": "DANIELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "6012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Endodontics LL
• Shayna Provencher, LCSW
• Proyecto El Parto, Inc.
• Psychiatric Medicine Center PC
• Psychiatric Medicine Center, PC
• Psychiatric Medicine Center, PC
• Psychiatric Medicine Center, PC

• Certified Registered Nurse Anesthetist in New London, CT
• Providers in New London, CT by specialty
• Certified Registered Nurse Anesthetist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.