KATIE M. MARCUCCIO (NPI# 1790030567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790030567 |
| Entity Type | Individual |
| Full Name | KATIE M. MARCUCCIO |
| Credential | CRNA |
| Practice Address |
326 Washington St Dept of Anesthesia Norwich CT 06360-2740 |
| Mailing Address |
68 S Service Rd Suite 350 Melville NY 11747-2354 |
| Practice Telephone | 8608898331 |
| Mailing Telephone | 5169453034 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | RN263394 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 04997 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110130192A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Lake Ave N, Worcester, MA 016550002 | 5083343271 | 5088565911 |
| Street Address |
326 WASHINGTON ST DEPT OF ANESTHESIA |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992076 | Lisa Ann White | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2005-06-15 |
| 1942818380 | Janankia Andrea Thomas | Counselor | 326 Washington St, Norwich, CT 06360-2740 | 2020-07-22 |
| 1306467170 | Hannah Perna | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2020-05-02 |
| 1851920540 | Nicole Patricia Golden | Registered Nurse | 326 Washington St, Norwich, CT 06360-2740 | 2020-04-04 |
| 1154955854 | Brynne E Radel | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2020-03-03 |
| 1801359955 | James Dreier | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2019-04-07 |
| 1346715349 | Aldo Mauricio Velasquez | Physician Assistant | 326 Washington St, Norwich, CT 06360 | 2018-10-05 |
| 1073092557 | Devin Stanton | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-08-07 |
| 1699260737 | Kevin Connolly | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-06-29 |
| 1275034456 | Lori A Desbonnet | Social Worker | 326 Washington St, Norwich, CT 06360-2740 | 2018-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912960584 | John P Newcomb | Nurse Anesthetist, Certified Registered | Washington St, Norwich, CT 06360 | 2006-04-06 |
| 1881662138 | Wendy M. Carrington | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360 | 2006-03-12 |
| 1154955854 | Brynne E Radel | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2020-03-03 |
| 1801359955 | James Dreier | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2019-04-07 |
| 1356891733 | Kalie Morrissette | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2016-10-10 |
| 1275885436 | Lois Caldrello | Nurse Anesthetist, Certified Registered | 326 Washington St, Dept of Anesthesia, Norwich, CT 06360-2740 | 2012-10-11 |
| 1861778953 | Meredith Susan Connell | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2011-11-02 |
| 1801128608 | Marek Pilecki | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2010-02-03 |
| 1265600704 | Sandra C Jeppesen | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2008-02-19 |
| 1992909238 | Gail W Bettencourt | Nurse Anesthetist, Certified Registered | 326 Washington Street, Norwich, CT 06360 | 2007-06-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.