Individual provider Active NPI

Kelly Jean Way, BS, MS, PA-C

  • Medical Physician Assistant
  • Norwich, CT
National Provider Identifier
1124274378
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002126 Issued in CT
Practice address
326 Washington St
Norwich, CT 06360-2740
Phone
(860) 889-8331
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002126 CT Primary
Medical Physician Assistant 363AM0700X PA00473 RI

Addresses

Primary practice location

326 Washington St
Norwich, CT 06360-2740

Mailing address

34B Springbrook Rd
Westerly, RI 02891-1001
Phone (401) 348-8565

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
I20081106000501 CT Practitioner - Physician Assistant 1355400201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
2126CTMDMental Health Counselor
002126CTMDClinical Social Worker
PA00473RIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
William W Backus Hospital CurrentSince Jul 29, 2008 Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

Organizations & group practices 2

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 3

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1124274378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34B SPRINGBROOK RD",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028911001",
            "telephone_number": "401-348-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 WASHINGTON ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602740",
            "telephone_number": "860-889-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAY",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "BS, MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "002126",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00473",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.