Individual provider Active NPI

Marcy Ann Kesilewski, PA-C

  • Physician Assistant
  • Hamden, CT
National Provider Identifier
1073580833
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001413 Issued in CT
Practice address
275 Mount Carmel Ave BLDG 4
Hamden, CT 06518-1905
Phone
(203) 582-8545
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001413 CT Primary

Addresses

Primary practice location

275 Mount Carmel Ave BLDG 4
Hamden, CT 06518-1905

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (203) 407-4050

Other identifiers 1

IdentifierTypeStateIssuer
2V5067OtherCTHEALTHNET

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000114 CT Practitioner - Physician Assistant 4284527128 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1413CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 1, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc Physician Assistant CurrentSince May 1, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Medhelp PC Past Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Fl 1
Wethersfield, CT 06109
Phone (860) 972-6970

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: marcy.carrera@xdr.hhchealthdirect.org
  • FHIR API: https://api.platform.athenahealth.com/17217/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1073580833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "203-407-4050",
            "fax_number": "203-616-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE BLDG 4",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181905",
            "telephone_number": "203-582-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESILEWSKI",
        "first_name": "MARCY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V5067",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.