Individual provider Active NPI

Kelsey Ejzak Caulfield, PA

  • Medical Physician Assistant
  • Portland, CT
National Provider Identifier
1245462589
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2312 Issued in CT
Practice address
270 Main St Ste a
Portland, CT 06480-1836
Phone
(860) 358-5040
NPI assigned
Aug 20, 2009
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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
Medical Physician Assistant 363AM0700X 2312 CT Primary

Addresses

Primary practice location

270 Main St Ste a
Portland, CT 06480-1836

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-4870

Other practice location 1

42 Town St
Norwich, CT 06360-2316
Phone (860) 480-0135

Other practice location 2

27 William F Palmer Rd
Moodus, CT 06469-1132
Phone (860) 358-5220

Other names 1

  • Miss Kelsey Elizabeth Ejzak Former name

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
I20091016000436 CT Practitioner - Physician Assistant 7214074640 Reassigns benefits to 7 organizations

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
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

27 William F Palmer Rd
Moodus, CT 06469-1132
Phone (860) 358-5220

270 Main St
Suite a
Portland, CT 06480-1836
Phone (860) 358-5040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2312CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jul 15, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc Physician Assistant CurrentSince Aug 1, 2017 Accepting new patients
MHS Primary Care Inc Physician Assistant CurrentSince Jul 1, 2023 Accepting new patients
Lawrence and Memorial Hospital, Inc. CurrentSince Jun 12, 2011 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jul 15, 2022 Accepting new patients
MHS Primary Care Physician Assistant CurrentSince Jan 16, 2023 Accepting new patients
MHS Primary Care Inc Physician Assistant CurrentSince Jan 16, 2023 Accepting new patients
MHS Primary Care, Inc Physician Assistant Past Accepting new patients

Locations

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

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

896 Washington St
Middletown, CT 06457
Phone (860) 788-3632

27 William F Palmer Rd
Moodus, CT 06469
Phone (860) 358-5220

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

270 Main St
Ste A
Portland, CT 06480
Phone (860) 358-5040

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

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

Interoperability endpoints

  • Direct secure messaging: kcaulfield79980@middlesexhealthprd.direct-ci.com

Organizations & group practices 11

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

Hospital & facility affiliations 1

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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1245462589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 MAIN ST STE A",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801836",
            "telephone_number": "860-358-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Town St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602316",
            "country_code": "US",
            "telephone_number": "860-480-0135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27 William F Palmer Rd",
            "address_purpose": "LOCATION",
            "city": "Moodus",
            "state": "CT",
            "postal_code": "064691132",
            "country_code": "US",
            "telephone_number": "860-358-5220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAULFIELD",
        "first_name": "KELSEY",
        "middle_name": "EJZAK",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "2312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "EJZAK",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, CT

Sources for this page

Verify at the official NPI Registry.