Georgia Ann Kelley, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

034092 Issued in CT

Practice address

100 Broadway
North Haven, CT 06473-2365

Phone

(203) 234-1891

Fax

(203) 234-2678

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Masonicare Home Health & Hospice, Inc Home health agency, Wallingford, CT, CCN 077159
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
• The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
• Gaylord Hospital Inc Long-term care hospital, Wallingford, CT, CCN 072003

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkelley3584@direct.ynhh.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Gaylord Hospital, Inc.

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753

  Long-term care hospital

  Care Compare affiliation
• Masonicare Home Health and Hospice, Inc.

  • Home Health Agency
  • Wallingford, CT
  • NPI 1710976220
  Care Compare affiliation
• New Britain General Hospital

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1548225360
  Care Compare affiliation
• The Hospital of Central Connecticut at New Britain General and Bradley

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1053477075
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1013945211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732365",
            "telephone_number": "203-234-1891",
            "fax_number": "203-234-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732365",
            "telephone_number": "203-234-1891",
            "fax_number": "203-234-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GEORGIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "034092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0488063",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010034092CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "061535742",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P499703",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "01034092",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001340926",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110180478",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTCARE",
            "identifier": "340920",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0Q1536",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Otto Kastenhuber, LMSW
• Kathryn L. McGibbon, LCSW, LLC
• Meredith Wallace Kazer, PHD, APRN-BC
• Daniel Jones Keady, LPC
• Alexander John Keklik, PA-C
• Jennine Kelley, A.U.D
• Erica Kelly
• Danit Kenigsztein, LPC
• Kennedy & Perkins, Inc.
• Brian J Kennedy, CAC

• Internal Medicine Physician in North Haven, CT
• Providers in North Haven, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.