Individual provider Active NPI

Jane M Grant-Kels, M.D.

  • Dermatology Physician
  • Farmington, CT
National Provider Identifier
1750386462
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
021687 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-0001
Phone
(860) 679-4600
Fax
(860) 679-1248
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME132882 FL
Dermatology Physician 207N00000X 021687 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-0001

Mailing address

65 Kane St
West Hartford, CT 06119-2110
Phone (860) 523-6421

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-0279
Phone (352) 594-1919

Other identifiers 1

IdentifierTypeStateIssuer
101119600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgrantkels10766@direct.med.uchc.edu

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100923001109 CT Practitioner - Dermatology 5092831396 Reassigns benefits to 1 organization
I20181228000400 FL Practitioner - Dermatology 5092831396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
JS Weill Medical College, Cornell University, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21 S Rd
Farmington, CT 06032-2482
Phone (860) 679-4600

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

263 Farmington Ave
Farmington, CT 06030-8082

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions84
Skin biopsy34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021687CTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2018 Accepting new patients
University of Connecticut Health Center CurrentSince Sep 15, 1987 Accepting new patients
University of Connecticut Health Center Dermatology CurrentSince Sep 15, 1987 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2018 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

21 South Rd
Farmington, CT 06032
Phone (860) 679-4600

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

65 Kane St
West Hartfrd, CT 06119
Phone (860) 523-6421

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jgrantkels408122@direct.shands.ufl.edu

Organizations & group practices 5

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1750386462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 KANE ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061192110",
            "telephone_number": "860-523-6421",
            "fax_number": "860-523-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-1248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326100279",
            "country_code": "US",
            "telephone_number": "352-594-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT-KELS",
        "first_name": "JANE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME132882",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "021687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101119600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgrantkels10766@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.