Individual provider Active NPI

Benjamin Webster, CRNA

  • Certified Registered Nurse Anesthetist
  • New London, CT
National Provider Identifier
1770918989
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
082865 Issued in CT
Practice address
365 Montauk Ave
New London, CT 06320-4700
Phone
(860) 442-0711
Fax
(781) 407-0998
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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 082865 CT Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320-4700

Mailing address

690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone (781) 407-7713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131122001809 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294961157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
082865CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Middletown, P.C. CurrentSince Jul 18, 2022 Accepting new patients

Locations

145 S Main St
Middletown, CT 06457
Phone (860) 346-5889

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

410 Saybrook Rd
Middletown, CT 06457
Phone (615) 686-2262

140 Cross Rd
Waterford, CT 06385
Phone (860) 701-0140

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1770918989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711",
            "fax_number": "781-407-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "BENJAMIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "082865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.