Individual provider Active NPI

Benjamin L Stafford, CRNA

  • Certified Registered Nurse Anesthetist
  • Laconia, NH
National Provider Identifier
1720398175
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
065099-23 Issued in NH
Practice address
80 Highland Street
Laconia, NH 03246-3235
Phone
(603) 524-3211
Fax
(660) 826-4852
NPI assigned
Oct 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 213865 NC
Certified Registered Nurse Anesthetist 367500000X 065099-23 NH Primary

Addresses

Primary practice location

80 Highland Street
Laconia, NH 03246-3235

Mailing address

PO Box 190
Laconia, NH 03247-0190
Phone (603) 524-3211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000754 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961681457 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 2365418993, 79 clinicians

Practice addresses (Care Compare)

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

Hospital & facility affiliations

  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
213865NCMDCertified Registered Nurse Anesthetist
065099-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Current Accepting new patients
Lrghealthcare CurrentSince Jan 1, 2019 Accepting new patients
Memorial Hospital CurrentSince Apr 1, 2019 Accepting new patients
Memorial Hospital CurrentSince Apr 1, 2019 Accepting new patients
Concord Hospital-Franklin CurrentSince Jan 1, 2019 Accepting new patients

Locations

15 Aiken Ave
Franklin, NH 03235
Phone (603) 934-2060

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Organizations & group practices 5

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 5

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1720398175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032470190",
            "telephone_number": "603-524-3211",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HIGHLAND STREET",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032463235",
            "telephone_number": "603-524-3211",
            "fax_number": "660-826-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "213865",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "065099-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laconia, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.