Individual provider Active NPI

Kimberley Anne Waskowitz, CRNA

  • Certified Registered Nurse Anesthetist
  • Manchester, CT
National Provider Identifier
1972521102
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
002704 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 646-1222
NPI assigned
Jul 17, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 002704 CT Primary
Certified Registered Nurse Anesthetist 367500000X 052720 CT

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

7 Wynwood Dr
Cromwell, CT 06416-2524
Phone (860) 632-9233

Other names 1

  • Kimberley Anne Simeone Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000820 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234124793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiologists of Middletown, P.C.Group PAC ID 2769479781, 34 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 347-0720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2704CTMDProfessional Counselor
052720CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Middletown, P.C. CurrentSince Feb 8, 2010 Accepting new patients
Mdsine, LLC Past Accepting new patients
Hartford Anesthesiology Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Patriot Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Milford Anesthesia Associates LLC Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 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

51 S Main St
Middletown, CT 06457
Phone (860) 344-0055

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1972521102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WYNWOOD DR",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162524",
            "telephone_number": "860-632-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKOWITZ",
        "first_name": "KIMBERLEY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "002704",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "052720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "SIMEONE",
            "middle_name": "ANNE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.