Individual provider Active NPI

Mary D Stepanek, CRNA

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1750397931
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
002836 Issued in CT
Practice address
1423 Chapel St
New Haven, CT 06511
Phone
(203) 865-3852
Fax
(203) 865-2983
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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 002836 CT Primary

Addresses

Primary practice location

1423 Chapel St
New Haven, CT 06511

Mailing address

100 Ruggles Rd
Guilford, CT 06437
Phone (203) 453-6234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130128000027 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820097165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
002836CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SMG Anesthesia Specialists LLC CurrentSince Mar 1, 2013 Accepting new patients
Sentara Medical Group CurrentSince Jan 14, 2013 Accepting new patients
Farmington Surgery Center LLC Past Accepting new patients
Hartford Anesthesiology Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3000 Coliseum Dr
Hampton, VA 23666
Phone (757) 736-1000

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

Organizations & group practices 4

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 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1750397931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RUGGLES RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "06437",
            "telephone_number": "203-453-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-865-3852",
            "fax_number": "203-865-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANEK",
        "first_name": "MARY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "002836",
            "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 Oct 23, 2012; 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.