Individual provider Active NPI

Kelly Martinez, PA

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1669669727
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
114 Woodland St
Department of Surgery
Hartford, CT 06105-1208
Phone
(860) 714-4694
Fax
(860) 714-8096
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

114 Woodland St
Department of Surgery
Hartford, CT 06105-1208

Mailing address

114 Woodland St
Department of Surgery
Hartford, CT 06105-1208
Phone (860) 714-4694

Other names 1

  • Kelly Biafore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071211000365 CT Practitioner - Physician Assistant 7911096169 Reassigns benefits to 1 organization
I20200825001315 FL Practitioner - Physician Assistant 7911096169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collier Hma Physician Management LLCGroup PAC ID 2769495167, 99 clinicians

Practice addresses (Care Compare)

6101 Pine Ridge Rd
Naples, FL 34119-3900

Hospital & facility affiliations

  • Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1959CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Hma Physician Management LLC CurrentSince Sep 14, 2020 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 23, 2007 Accepting new patients

Locations

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

6101 Pine Ridge Rd
Ste 114
Naples, FL 34119

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kelly.rousseau.1@4692.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1669669727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4694",
            "fax_number": "860-714-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4694",
            "fax_number": "860-714-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BIAFORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.