Individual provider Active NPI

Kyla Giannelli

  • Medical Physician Assistant
  • Hartford, CT
National Provider Identifier
1083845226
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2390 Issued in CT
Practice address
100 Retreat Ave
Suite 811
Hartford, CT 06106-2528
Phone
(860) 522-5712
Fax
(860) 520-4270
NPI assigned
Aug 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3807 MA
Medical Physician Assistant 363AM0700X 2390 CT Primary

Addresses

Primary practice location

100 Retreat Ave
Suite 811
Hartford, CT 06106-2528

Mailing address

100 Retreat Ave
Suite 811
Hartford, CT 06106-2528
Phone (860) 522-5712

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
I20100429000846 CT Practitioner - Physician Assistant 3779610399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

100 Retreat Ave
Suite 705
Hartford, CT 06106-2553
Phone (860) 278-0070

11 S Rd
Farmington, CT 06032-2483

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jul 15, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jul 15, 2021 Accepting new patients
Connecticut Heart Physicians, Inc. PastSince Jul 24, 2006 Accepting new patients

Locations

100 Retreat Ave
Ste 811
Hartford, CT 06106
Phone (860) 522-5712

85 Seymour St
Ste 719
Hartford, CT 06106
Phone (860) 249-9175

376 Tolland Tpke
Ste 101
Manchester, CT 06042
Phone (860) 522-5712

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

1290 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 224-5305

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

Interoperability endpoints

  • Direct secure messaging: kyla.giannelli@xdr.hhchealthdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1083845226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 811",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062528",
            "telephone_number": "860-522-5712",
            "fax_number": "860-520-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 811",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062528",
            "telephone_number": "860-522-5712",
            "fax_number": "860-520-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNELLI",
        "first_name": "KYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3807",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "2390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.