Individual provider Active NPI

Jacob A. Kapplan, NURSE ANESTHESIST

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1700254331
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2353222 Issued in MA
Practice address
333 Cedar St # ST3
New Haven, CT 06510-3206
Phone
(860) 972-2797
NPI assigned
Sep 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 089214 CT
Certified Registered Nurse Anesthetist 367500000X 089214 CT
Certified Registered Nurse Anesthetist 367500000X RN2353222 MA Primary

Addresses

Primary practice location

333 Cedar St # ST3
New Haven, CT 06510-3206

Mailing address

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-5808

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170425000802 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981905049 Reassigns benefits to 5 organizations
I20210913000728 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981905049 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland Anesthesia Associates PCGroup PAC ID 8820083652, 172 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-6654

271 Carew St
Springfield, MA 01104-2377
Phone (860) 714-9688

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
089214CTMDRegistered Nurse
RN2353222MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Medical Center Inc. CurrentSince Apr 4, 2022 Accepting new patients
Lahey Clinic, Inc. CurrentSince Sep 7, 2021 Accepting new patients
Berkshire Medical Center, Inc CurrentSince Apr 4, 2022 Accepting new patients
Charter Anesthesiology LLC CurrentSince Jun 12, 2021 Accepting new patients
Yale University CurrentSince Jul 1, 2020 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jan 29, 2024 Accepting new patients
Lahey Clinic, Inc CurrentSince Sep 7, 2021 Accepting new patients
Connecticut Gi PLLC CurrentSince Aug 1, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 29, 2024 Accepting new patients
Yale University CurrentSince Jul 1, 2020 Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

333 Cedar St
#3
New Haven, CT 06510
Phone (203) 737-1549

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

20 York St
North Haven, CT 06510
Phone (203) 688-2433

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

245 Alvord Park Rd
Bldg B
Torrington, CT 06790
Phone (860) 482-4866

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 12

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1700254331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST # ST3",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "860-972-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPPLAN",
        "first_name": "JACOB",
        "middle_name": "A.",
        "credential": "NURSE ANESTHESIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "089214",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "089214",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2353222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.