Gresi Kello, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4810 Issued in CT

Practice address

2165 Dixwell Ave
Hamden, CT 06514-2116

Phone

(860) 430-1246

NPI assigned

Sep 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• WRK Ventures, LLC

  dba Urgent Care of Southbury

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1609481639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CONGRESS AVE APT 407",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191410",
            "telephone_number": "860-849-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142116",
            "telephone_number": "860-430-1246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "493 Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065112394",
            "country_code": "US",
            "telephone_number": "860-430-1246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLO",
        "first_name": "GRESI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin E. Katz, MD
• Jennifer Kazdan, LCSW
• Erin Mullaney Keane, RN, PPCNP-BC
• Lynsey McGrath Keator
• Amanda Kedzior
• Susan Kelly, LADC, CAC
• Stephanie Kelsey-Reynolds, OTR L
• Kathryn Blaney Kennedy, LPC
• Karin E Kerfoot, MD
• Marcy Ann Kesilewski, PA-C

• Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.