Individual provider Active NPI

Crystal May Kubelle, DNP

  • Certified Registered Nurse Anesthetist
  • Norwalk, CT
National Provider Identifier
1730679911
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
118214 Issued in CT
Practice address
24 Stevens St
Norwalk, CT 06850
Phone
(203) 852-3141
Fax
(203) 852-2527
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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 118214 CT Primary

Addresses

Primary practice location

24 Stevens St
Norwalk, CT 06850

Mailing address

34 Maple St
Norwalk, CT 06850-3815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920001061 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719238393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

40 Cross St
Norwalk, CT 06851-4647
Phone (203) 546-3377

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118214CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jul 28, 2018 Accepting new patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Sep 24, 2018 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

40 Cross St
Norwalk, CT 06851
Phone (203) 845-2020

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

7365 Main St
Ste 310
Stratford, CT 06614
Phone (203) 384-3174

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1730679911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 STEVENS ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "06850",
            "telephone_number": "203-852-3141",
            "fax_number": "203-852-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBELLE",
        "first_name": "CRYSTAL",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "118214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.