Individual provider Active NPI

Mary Ellen Dwyer, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • East Hartford, CT
National Provider Identifier
1619936119
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
001361 Issued in CT
Practice address
111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone
(860) 282-4137
Fax
(860) 282-0170
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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 001361 CT Primary

Addresses

Primary practice location

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212

Mailing address

300 George St
FL 6
New Haven, CT 06511-6624
Phone (860) 282-4137

Other identifiers 1

IdentifierTypeStateIssuer
004231221MedicaidCT

Other names 1

  • Mary Ellen Mason Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000490 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365345683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001361CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Apr 1, 2016 Accepting new patients
Yale University CurrentSince Apr 1, 2016 Accepting new patients
Hartford Anesthesiology Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

1450 Chapel St
Ste B
New Haven, CT 06511
Phone 20386754204405

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

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

Interoperability endpoints

  • Direct secure messaging: mdwyer334936@direct.ynhh.org

Organizations & group practices 3

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 2

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1619936119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST",
            "address_2": "FL 6",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116624",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "MARY ELLEN",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "001361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004231221",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "MASON",
            "credential": "APRN, CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.