KATHLEEN A KELLEY – Physician Assistant, NPI 1952773525

KATHLEEN A KELLEY is a healthcare provider. based in Orange, Connecticut. specializing in Physician Assistant. They hold a License No. 3442 (CT). The NPI Number for KATHLEEN A KELLEY is 1952773525

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN A KELLEY
NPI
1952773525
Phone
(203) 795-4784
Address
330 Boston Post Rd
Enumeration Date
22 October 2015
Last Update Date
30 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8603451143
Graduation Year
2015 (11 years ago)
PAC ID
1850695420
Group Practice PAC ID
0941455695
Professional Enrollment ID
I20160203000238
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for KATHLEEN A KELLEY

  • 330 Boston Post Rd

    Orange, CT 064773505

    Phone: (203) 795-4784

    Fax: (203) 799-1179

    Type: Location

  • 31 BEECHWOOD RD

    BRANFORD, CT 064053203

    Phone: (203) 640-8523

    Type: Mailing

  • 464 CONGRESS AVE

    SUITE 260

    NEW HAVEN, CT 065191361

    Phone: (203) 785-4404

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160203000238IPhysician AssistantCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06477)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941455695View full group profile

Reviews

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Frequently asked questions

Is KATHLEEN A KELLEY listed with a National Provider Identifier?
Yes — KATHLEEN A KELLEY has NPI 1952773525 on file in the registry.
Is KATHLEEN A KELLEY still an active registrant?
KATHLEEN A KELLEY carries an active NPI according to the public dataset.
What kind of doctor is KATHLEEN A KELLEY?
KATHLEEN A KELLEY is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is KATHLEEN A KELLEY associated with Orange?
Public fields place KATHLEEN A KELLEY around Orange, Connecticut. Always confirm the exact site before visiting.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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