Individual provider Active NPI

Kelly Ann Rainey, P.A.

  • Surgical Physician Assistant
  • Middletown, CT
National Provider Identifier
1699733477
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
000930 Issued in CT
Practice address
28 Crescent St
Middletown, CT 06457-3654
Phone
(860) 358-6620
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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 000930 CT
Surgical Physician Assistant 363AS0400X 000930 CT Primary

Addresses

Primary practice location

28 Crescent St
Middletown, CT 06457-3654

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6620

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
I20081216000700 CT Practitioner - Physician Assistant 0042372609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

14 Jones Hollow Rd
Suite 2
Marlborough, CT 06447-1448
Phone (860) 358-2850

28 Crescent St
Middletown, CT 06457-3654

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000930CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Norwich Orthopedic Group, P.C. CurrentSince Oct 19, 2019 Accepting new patients
MHS Primary Care, Inc Physician Assistant CurrentSince Mar 15, 2017 Accepting new patients
Norwich Orthopedic Group, P.C. CurrentSince Oct 19, 2019 Accepting new patients
MHS Primary Care Inc Physician Assistant CurrentSince Mar 15, 2017 Accepting new patients
Middlesex Hospital Past Accepting new patients
Middlesex Hospital PastSince Sep 1, 2001 Accepting new patients

Locations

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

540 Saybrook Rd
Ste 100B
Middletown, CT 06457
Phone (860) 347-6683

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

540 Saybrook Rd
Ste 100A
Middletown, CT 06457
Phone (860) 347-9377

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

82 New Park Ave
North Franklin, CT 06254
Phone (860) 889-7345

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

Interoperability endpoints

  • Direct secure messaging: krainey11425@middlesexhealthprd.direct-ci.com

Organizations & group practices 6

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 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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1699733477",
    "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": "860-358-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000930",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "000930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.