Individual provider Active NPI

Elizabeth Elam, CRNA

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
National Provider Identifier
1801841796
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
E57429 Issued in CT
Practice address
267 Grant St
Bridgeport Anesthesia Associates, PC
Bridgeport, CT 06610-2805
Phone
(203) 384-3072
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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 E57429 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport Anesthesia Associates, PC
Bridgeport, CT 06610-2805

Mailing address

7365 Main St
Suite 310
Stratford, CT 06614-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060426000761 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850301433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
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)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1510

2800 Main St
Bridgeport, CT 06606-4201
Phone (877) 442-2455

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3377CTMDMedical Physician Assistant
E57429CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amsurg Stamford Anesthesia LLC CurrentSince Apr 21, 2014 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2011 Accepting new patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

30 Waterchase Dr
Ste 2
Rocky Hill, CT 06067

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (860) 282-4128

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

778 Long Ridge Rd
Stamford, CT 06902
Phone (203) 322-2400

Organizations & group practices 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1801841796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "address_2": "SUITE 310",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "address_2": "BRIDGEPORT ANESTHESIA ASSOCIATES, PC",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "E57429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.