Kathleen A Kelley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3442 Issued in CT

Practice address

464 Congress Ave
Suite 260
New Haven, CT 06519-1361

Phone

(203) 785-4404

NPI assigned

Oct 22, 2015

Last updated

Jun 30, 2023By the provider in NPPES

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

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care Medical Center LLC

  dba Priority Urgent Care

  • Urgent Care Clinic/Center
  • Ellington, CT
  • NPI 1295186286
  Medicare reassignment
• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment
• Yale University

  • Adult Mental Health Clinic/Center
  • Hamden, CT
  • NPI 1134391824
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1952773525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BEECHWOOD RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053203",
            "telephone_number": "203-640-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 CONGRESS AVE",
            "address_2": "SUITE 260",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191361",
            "telephone_number": "203-785-4404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Boston Post Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773505",
            "country_code": "US",
            "telephone_number": "203-795-4784",
            "fax_number": "203-799-1179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Caitlin Keepers, MD, MBA
• Britton Conroy Keeshan, MD, MPH
• Cara Keifer, PHD
• Johnisha Keitazulu
• Christopher Kellet
• Meaghan Kelley
• Daniel S Kellner, MD
• David Kellner
• Jessica A Kelly-Hauser, APRN
• Amy Kelly, LCSW

• Physician Assistant in New Haven, CT
• Providers in New Haven, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.