Kimberly L Bellavance, MPAS

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2714 Issued in CT

Practice address

114 Woodland St
Surgery Dept.
Hartford, CT 06105-1208

Phone

(860) 714-4694

Fax

(860) 714-8096

NPI assigned

Jan 9, 2012

Last updated

Feb 13, 2012By 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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbellavance2389277@direct.trinity-health.org

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.

• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment Care Compare group
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1962772939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2109A",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-6581",
            "fax_number": "860-714-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "SURGERY DEPT.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4694",
            "fax_number": "860-714-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAVANCE",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "2714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaquoi Marquis Belin
• Steven A Belinkie, M.D.
• Jennifer Bell, MD
• Mark R Bell, M.D.
• Melissa Dierdre Bellanfante, LCSW
• Peter James Beller, MD
• Teresa Angela Bellmund, APRN
• Mark Belsky, MD
• Sharon R Belton, MSW
• Liel Ben Naim, DDS

• Surgical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.

Verify at the official NPI Registry.