Kelsey Bestall
Individual provider Active NPI Surgical Physician Assistant · New London, CT
NPI 1295213320 · NPPES record last updated May 23, 2023
Key facts
- NPI
- 1295213320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- Practice address
- 365 Montauk Ave
New London, CT 06320-4700 - Phone
- (860) 442-0711
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Yale University
Practice addresses (Care Compare)
800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140
Hospital & facility affiliations
- Lawrence & Memorial Hospital
- Westerly Hospital
- Yale-New Haven Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181227001211 | CT | Practitioner - Physician Assistant | 2961747613 | Reassigns benefits to 2 organizations |
| I20190314002027 | RI | Practitioner - Physician Assistant | 2961747613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4279 | CT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current |
Accepting new patients | |
| Northeast Medical Group, Inc. | Current |
Accepting new patients | |
| Mill Hill Medical Consultants Inc | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients | |
| WRK Ventures, LLC | Past | Accepting new patients |
Locations
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
99 Hawley Ln
Fl 3
Stratford, CT 06614
Phone (203) 502-4650
45 East Ave
Westerly, RI 02891
Phone (401) 596-6000
Interoperability endpoints
- kbestall347430@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Yes |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4700
Mailing address
365 Montauk Ave
New London, CT 06320-4700
Other providers in New London, CT
- Cedric Benson
- Calvin T Berg
- Rachel Elizabeth Bergeron
- Iris June Bernau
- Gary M. Bertman
- Tiffany Galicia Beyer
- Alan L Bier
- Stephanie Birch
- John Bitters
- Shauna Rochelle Blake
All providers in New London, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.