Individual provider Active NPI

Molly Deacutis, MD

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1952795171
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD482874 Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(215) 590-1858
Fax
(215) 590-1415
NPI assigned
Mar 25, 2015
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 067596 CT
Pediatric Anesthesiology Physician 207LP3000X MD482874 PA Primary
Pediatric Anesthesiology Physician 207LP3000X 067596 CT

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319
Phone (267) 425-9300

Other practice location 1

20 York Street
Department of Anesthesiology
New Haven, CT 06510
Phone (203) 785-2802

Other practice location 2

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-5522

Other practice location 3

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-7737

Other practice location 4

1450 Chapel Street, E2006
Department of Anesthesiology
New Haven, CT 06511
Phone (203) 789-3538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211004001027 CT Practitioner - AnesthesiologyPractitioner - Other (Physician) 1557641131 Reassigns benefits to 1 organization
I20240305000853 PA Practitioner - Anesthesiology 1557641131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
067596CTMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Anesthesiology CurrentSince Sep 16, 2021 Accepting new patients
Yale University CurrentSince Sep 16, 2021 Accepting new patients
Children's Anesthesiology Associates, LTD Anesthesiology CurrentSince Jan 22, 2024 Accepting new patients
Children's Anesthesiology Associates, LTD Anesthesiology CurrentSince Jan 22, 2024 Accepting new patients

Locations

1450 Chapel St
#E2006
New Haven, CT 06511
Phone (203) 789-3538

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

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

20 York St
North Haven, CT 06510
Phone (203) 688-2433

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1952795171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "267-425-9300",
            "fax_number": "267-443-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York Street",
            "address_2": "Department of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06510",
            "country_code": "US",
            "telephone_number": "203-785-2802",
            "fax_number": "203-785-6664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-5522",
            "fax_number": "717-531-0826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-7737",
            "fax_number": "617-730-0199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 Chapel Street, E2006",
            "address_2": "Department of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06511",
            "country_code": "US",
            "telephone_number": "203-789-3538",
            "fax_number": "203-867-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEACUTIS",
        "first_name": "MOLLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "067596",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD482874",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CT",
            "license": "067596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.