Active NPI
Kateland Heidi Kelly, PA-C
- Physician Assistant
- New Milford, CT
National Provider Identifier
1700178191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5214
- Practice address
- 11 Old Park Lane Rd
New Milford, CT 06776-2507 - Phone
- (860) 355-1149
- Fax
- (860) 210-2008
- NPI assigned
- May 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 055.0031323 | VT | |
| Physician Assistant | 363A00000X | 5214 | CT | Primary |
Addresses
Primary practice location
11 Old Park Lane Rd
New Milford, CT 06776-2507
Mailing address
11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone (860) 355-1149
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11 Old Park Lane
New Milford, CT 06776-2507
11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone (860) 355-1149
Hospital & facility affiliations
- Western Connecticut Home Care Inc
- Danbury Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 46.05 of 100
- Quality
- 10.81
- Promoting interoperability
- 77
- Improvement activities
- 0
- Cost
- 76.57
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.63 of 100
- Quality
- 62.23
- Improvement activities
- 40
- Cost
- 81.29
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5214 | CT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yakima Neighborhood Health Services | Past | Accepting new patients | |
| Clearchoicemd Primary Care PLLC | Past | Accepting new patients |
Interoperability endpoints
- kateland.kelly.p1@direct.nmmg.nextgenshare.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.
-
- Internal Medicine Physician
- New Milford, CT
- NPI 1356403323
-
- Family Medicine Physician
- Saint Albans, VT
- NPI 1326582529
-
- Federally Qualified Health Center (FQHC)
- Yakima, WA
- NPI 1225085624
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Danbury, CT
- NPI 1548293343
-
- Home Health Agency
- Danbury, CT
- NPI 1083677132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1700178191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 OLD PARK LANE RD",
"city": "NEW MILFORD",
"state": "CT",
"postal_code": "067762507",
"telephone_number": "860-355-1149",
"fax_number": "860-210-2008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 OLD PARK LANE RD",
"city": "NEW MILFORD",
"state": "CT",
"postal_code": "067762507",
"telephone_number": "860-355-1149",
"fax_number": "860-210-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KATELAND",
"middle_name": "HEIDI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-04",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VT",
"license": "055.0031323",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "5214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.