DR. KELLEY LARSON ETHERIDGE (APRN/CRNA) – Certified Registered Nurse Anesthetist, NPI 1821574310
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
792 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CT
Provider Addresses for DR. KELLEY LARSON ETHERIDGE (APRN/CRNA)
114 Woodland St
Hartford, CT 061051208
Phone: (860) 714-4000
Type: Location
195 EASTERN BLVD
GLASTONBURY, CT 060334312
Phone: (860) 667-9542
Type: Location
Saint Francis Hospital and Medical Center, 114, Woodland Street, Upper Albany Historic District, Hartford, Hartford County, Connecticut, 06105, United States
HARTFORD, CT 061051208
Phone: (860) 714-4000
Type: Location
88, Black Walnut Drive, Royal Oak Park, Durham, Middlesex County, Connecticut, 06422, United States
DURHAM, CT 064221400
Phone: (860) 575-2052
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $94.
Total Amount is formed as General ($94) + Research ($0) + Ownership ($0) = $94.
Last reported payment date: 2024-02-29 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($71).
Total Amount
$94
General + Research + Ownership
Payments
5
Total payment records
General Amount
$94
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $71 |
| Takeda Pharmaceuticals U.S.A., Inc. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-09-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180910001083 | I | Certified Registered Nurse Anesthetist (Crna) | CT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 32 | 31 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 17 | 17 | $0 |
Insurance plans in this area (ZIP 06105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | CT | |
| Certified Registered Nurse Anesthetist (Crna) | CT | |
| - | CT | |
| Certified Registered Nurse Anesthetist (Crna) | CT | |
| A N E S T H E S I O L O G Y | CT | |
| A N E S T H E S I O L O G Y | CT | |
| - | MA | |
| - | CT | |
| Certified Registered Nurse Anesthetist (Crna) | CT | |
| - | CT |
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