Individual provider Active NPI

Kalin Haley

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1245613199
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3377 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-6000
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3377 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

56 Franklin St
Waterbury, CT 06706-1253

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 837-5506

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbilides225394@direct.stfranciscare.org Direct
Direct Messaging Address kbilides17128@direct.connecticutchildrens.org

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
I20151014001381 CT Practitioner - Physician Assistant 7810206844 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3377CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Aug 17, 2015 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

263 Farmington Ave
Farmington, CT 06032
Phone (860) 679-1706

100 Retreat Ave
Fl 5
Hartford, CT 06106
Phone (860) 837-5206

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

80 Seymour St
Fl 5
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

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

Interoperability endpoints

  • Direct secure messaging: khaley2390072@direct.trinity-health.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.

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1245613199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-837-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALEY",
        "first_name": "KALIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbilides225394@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "56 Franklin St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067061253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbilides17128@direct.connecticutchildrens.org",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.