Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samira Fisayo

Individual provider Certified Registered Nurse Anesthetist · NPI 1740851112

Samira Fisayo is a Certified Registered Nurse Anesthetist (CRNA) in New London, Connecticut. Qualified in 2021, 5 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2021
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Practice location Address checks out

365 Montauk Ave
New London, CT 06320-4769
Phone: (860) 442-0711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 9774 (CT)

Record details

NPI number1740851112
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 7, 2021
Last updated in NPPESJuly 7, 2021
Certification dateJune 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in New London