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MISS KELLY NICOLE HAFERS PA-C
NPI 1104408061
Physician Assistant in Bridgeport, CT

Active since April 21, 2021PECOS Enrolled
30 HAZEL ST, BRIDGEPORT, CT 06604(203) 576-4880 Get Directions Write a Review

NPPES record last updated: July 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2021, Jun 9, 2021, Apr 21, 2021 (3 updates tracked since 2021).

About Miss Kelly Nicole Hafers Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS KELLY NICOLE HAFERS PA-C (NPI 1104408061) is an individual physician assistant in Bridgeport, Connecticut and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Wyckoff.

NPPES Registry Identity

NPI1104408061
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMISS KELLY NICOLE HAFERSCredential: PA-C
Location Address30 HAZEL STBridgeport, CT 06604-7752
Mailing Address30 Hazel StBridgeport, CT 06604-7752 · (203) 576-4880
Phone(203) 576-4880
Sole ProprietorYes
Enumeration DateApril 21, 2021
Last NPPES UpdateJuly 13, 20213 updates tracked since enumeration
NPPES CertifiedJuly 13, 2021
✔ NPI 1104408061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
30 HAZEL ST, Bridgeport, CT 06604
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Secondary Practice Location 1

Location 148 Burma RdWyckoff, NJ 07481-3302 · Phone (201) 414-7303

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Kelly Nicole Hafers Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Hafers's NPI number?

The NPI number for Kelly Hafers is 1104408061. It was assigned to this individual provider in the NPPES registry on April 21, 2021.

Where is Kelly Hafers located?

Kelly Hafers practices at 30 Hazel St, Bridgeport, CT 06604. The listed phone number is (203) 576-4880.

What is Kelly Hafers's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kelly Hafers enrolled in Medicare?

Yes. Kelly Hafers is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Hafers was last updated on July 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.