Individual provider Active NPI

Hollie Suzanne Manzolillo, CRNA

  • Certified Registered Nurse Anesthetist
  • New Haven, CT
National Provider Identifier
1790069003
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
078840 Issued in CT
Practice address
1423 Chapel St
New Haven, CT 06511-4411
Phone
(203) 865-3852
Fax
(203) 865-2983
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 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 078840 CT Primary

Addresses

Primary practice location

1423 Chapel St
New Haven, CT 06511-4411

Mailing address

1423 Chapel St
New Haven, CT 06511-4411
Phone (203) 865-3852

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120227000243 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103084843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (860) 282-0833

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078840CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Mar 1, 2014 Accepting new patients
Yale University CurrentSince Mar 1, 2014 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2017 Accepting new patients
Woodland Anesthesia Associates PC Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

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 2

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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1790069003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114411",
            "telephone_number": "203-865-3852",
            "fax_number": "203-865-2983"
        },
        {
            "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": "065114411",
            "telephone_number": "203-865-3852",
            "fax_number": "203-865-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZOLILLO",
        "first_name": "HOLLIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "078840",
            "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 Jan 22, 2013; 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.