John Cleary

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

100 Retreat Ave Ste 900
Hartford, CT 06106-2553

Phone

(941) 258-8667

NPI assigned

Mar 20, 2023

Sex

Male

Sole proprietor

Yes

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

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Willimantic, PCGroup PAC ID 2163506353, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021
• Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Anesthesia Associates of Willimantic PC

  • Anesthesiology Physician
  • Willimantic, CT
  • NPI 1306905799
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Care Compare affiliation
• Windham Community Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Willimantic, CT
  • NPI 1023191467
  Care Compare affiliation

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1669174355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE STE 900",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE STE 900",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062553",
            "telephone_number": "941-258-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Claudomir
• Latoya Clayton
• Venecia Clayton
• Cleanslate Medical Group of Connecticut LLC
• Clearwater Counseling and Psychotherapy LLC
• Alexandra Christine Clement, MD
• Jessica M Clement, M.D.
• Adrienne Mary Clements, APRN
• Nicole Katheryn Clemons, PHARMD
• Fredo J Clermont, DNP, APRN

• Student in an Organized Health Care Education/Training Program in Hartford, CT
• Providers in Hartford, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.