SAMIRA FISAYO
NPI 1740851112
Nurse Anesthetist, Certified Registered in New London, CT
About Samira Fisayo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMIRA FISAYO (NPI 1740851112) is an individual nurse anesthetist, certified registered in New London, Connecticut, licensed in Connecticut (9774) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samira Fisayo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Samira Fisayo reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Guilford, CT 06437
- Reassigned Medicare billing, Connecticut enrollment
- 19 clinicians in this Medicare group
New Haven, CT 06511
- Reassigned Medicare billing, Connecticut enrollment
- 3,728 clinicians in this Medicare group
New Haven, CT 06510
- Reassigned Medicare billing, Connecticut enrollment
- Medicare enrollment name: Northeast Medical Group Inc
- 1,824 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06320 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW LONDON, CT 06320
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samira Fisayo's NPI number?
The NPI number for Samira Fisayo is 1740851112. It was assigned to this individual provider in the NPPES registry on July 7, 2021.
Where is Samira Fisayo located?
Samira Fisayo practices at 365 Montauk Ave, New London, CT 06320. The listed phone number is (860) 442-0711.
What is Samira Fisayo's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Samira Fisayo enrolled in Medicare?
Yes. Samira Fisayo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Samira Fisayo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samira Fisayo reassigns Medicare benefits to 3 organizations: New England Anesthesia Associates, LLC (Guilford, CT), Yale University (New Haven, CT) and Mill Hill Medical Consultants Inc (New Haven, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samira Fisayo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Samira Fisayo was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Samira Fisayo · NPI 1740851112
Nurse Anesthetist, Certified Registered physician in New London, Connecticut. Individual provider, active in the CMS NPPES registry since July 7, 2021.
## Identity
- **NPI:** 1740851112 (Entity type: Individual)
- **Enumerated:** July 7, 2021
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 9774 (Connecticut)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 365 MONTAUK AVE, New London, CT 06320-4769
- **Phone:** (860) 442-0711
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): New England Anesthesia Associates, LLC (NPI 1891388146, Guilford, CT); Yale University (NPI 1205822236, New Haven, CT); Mill Hill Medical Consultants Inc (NPI 1952624769, New Haven, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** July 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1740851112) · Data from the CMS NPPES public registry.