Leroy J Kelley III, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1496 Issued in MA

Practice address

24 Walpole St FL 1
Norwood, MA 02062-3356

Phone

(781) 762-4205

Fax

(781) 255-7905

NPI assigned

Nov 8, 2005

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1978

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8413/brand/1/csg/1/fhir/r4
• Direct secure messaging: ljkelleyiii@drkelleypod.emadirect.md

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.

• Norwood Podiatry Associates PC

  dba NPA Cape Ann Foot and Ankle

  • Podiatrist
  • Norwood, MA
  • NPI 1821089079
  Medicare reassignment NPD
• Npa Cape Ann Foot and Ankle LLC

  dba Cape Ann Foot and Ankle

  • Podiatrist
  • Gloucester, MA
  • NPI 1982176806
  Medicare reassignment NPD
• Norwood Podiatry Associates PC

  • Physical Therapist
  • Norwood, MA
  • NPI 1942504311
  Authorized official Same address or phone
• Premier Healthcare Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dartmouth, MA
  • NPI 1174089163
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1003897034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WALPOLE ST FL 1",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623356",
            "telephone_number": "781-762-4205",
            "fax_number": "781-255-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WALPOLE ST FL 1",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623356",
            "telephone_number": "781-762-4205",
            "fax_number": "781-255-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LEROY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "1496",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y70632",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "1496",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "V09521",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "042715679",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0335797",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "LXO122",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Agar, Psy.D. LLC
• Jessica Ann Keaney, MSPT
• Jack F Kearns, CRNA
• Keena N. Allen, Psy.D LLC (Allied Behavioral Healthcare)
• Emma Keidel, LICSW
• Kelly Williams LMHC LLC
• Amna Haq Khan, MD
• Holly Khang
• Constantine Khoury, M.D.
• Nabeel Khudairi, O.D.

• Podiatrist in Norwood, MA
• Providers in Norwood, MA by specialty
• Podiatrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.