Individual provider Active NPI

Judith Ann Connell, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1770610537
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
168552 Issued in MA
Practice address
330 Brookline Ave
Dept of Anesthesia, Critical Care & Pain Medicine
Boston, MA 02215-5400
Phone
(617) 726-3030
NPI assigned
Feb 28, 2007
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 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 168552 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Dept of Anesthesia, Critical Care & Pain Medicine
Boston, MA 02215-5400

Mailing address

330 Brookline Avenue
Dept of Anesthesia, Critical Care & Pain Medicine
Boston, MA 02215
Phone (617) 754-2675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040402000224 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103818133 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gbaa Holdings PLLCGroup PAC ID 4789944646, 22 clinicians

Practice addresses (Care Compare)

175 Worcester St
Wellesley, MA 02481-5514
Phone (617) 754-0800

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
168552MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jan 16, 2017 Accepting new patients
Boston Advanced Anesthesia, Inc CurrentSince Oct 31, 2013 Accepting new patients
Gbaa Holdings, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 21, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 25, 2001 Accepting new patients

Locations

45 Discovery Way
#A
Acton, MA 01720
Phone (617) 936-7683

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

85 1st Ave
Waltham, MA 02451
Phone (781) 647-7246

175 Worcester St
Wellesley Hls, MA 02481
Phone (617) 272-0004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1770610537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVENUE",
            "address_2": "DEPT OF ANESTHESIA, CRITICAL CARE & PAIN MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-754-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "DEPT OF ANESTHESIA, CRITICAL CARE & PAIN MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "168552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.