Mrs Latisha Monique Pettway, CRNA in New London, CT - Medicare Certified Registered Nurse Anesthetist (crna)

Mrs Latisha Monique Pettway, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in New London, Connecticut. She graduated from nursing school in 2011 and has 14 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Integrated Anesthesia Associates Llc, Valley Health Anesthesia Services, Llc and her current practice location is 365 Montauk Ave, New London, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 442-0711.

Mrs Latisha Monique Pettway is licensed to practice in Connecticut (license number 4954) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336422377.

Contact Information

	Mrs Latisha Monique Pettway, CRNA
	365 Montauk Ave, New London, CT 06320-4700
	(860) 442-0711
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Latisha Monique Pettway
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	14 Years
Location	365 Montauk Ave, New London, Connecticut
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Latisha Monique Pettway graduated from nursing school in 2011

NPI Data:

NPI Number: 1336422377
Provider Enumeration Date: 09/26/2011
Last Update Date: 07/13/2025

Medicare PECOS Information:

PECOS PAC ID: 1850558347
Enrollment ID: I20120213000016

Medical Identifiers

Medical identifiers for Mrs Latisha Monique Pettway such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336422377	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	4954 (Connecticut)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Winchester Medical Center	Winchester, VA	Hospital
Midstate Medical Center	Meriden, CT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Integrated Anesthesia Associates Llc	1759281165	348
Valley Health Anesthesia Services, Llc	3678002565	95

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Latisha Monique Pettway allows following entities to bill medicare on her behalf.

Entity Name	Integrated Anesthesia Associates Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881636397 PECOS PAC ID: 1759281165 Enrollment ID: O20040112000163

Entity Name	Endoscopy Center Of Connecticut, Llc
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1386757854 PECOS PAC ID: 0143226712 Enrollment ID: O20070117000018

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Latisha Monique Pettway is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Latisha Monique Pettway, CRNA 30 Austin St, New Haven, CT 06515-1236 Ph: (203) 387-7163	Mrs Latisha Monique Pettway, CRNA 365 Montauk Ave, New London, CT 06320-4700 Ph: (860) 442-0711

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in New London, CT

Judith Ann Mcgannon, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 365 Montauk, Lawrence And Memorial Hospital, New London, CT 06320 Phone: 860-442-0711
Tara M Huta, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 Fax: 781-407-0998
Sharon B Gallipeau, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711
Thomas Scott Long, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711
Jolene Marie Oliver, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 206-384-6204
Stefanie Guarino, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 Fax: 781-407-0998
Ekelechi Nwanju, CRNA, DNP Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 973-970-8044

Mrs Latisha Monique Pettway, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in New London, CT