Active NPI
Robert J Kelsey Jr., M.D.
- Specialist
- Chicago, IL
National Provider Identifier
1043238223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 333 E Superior St
Suite 444
Chicago, IL 60611-2654 - Phone
- (312) 943-0282
- Fax
- (312) 943-0284
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Primary |
Addresses
Primary practice location
333 E Superior St
Suite 444
Chicago, IL 60611-2654
Mailing address
333 E Superior St
Suite 444
Chicago, IL 60611-2654
Phone (312) 943-0282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01620273 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 5, 2023 through May 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036074402 | IL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicago Womens Health Group | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIGGAA/Endpoint/BIGGAA
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Service Clinic/Center
- Chicago, IL
- NPI 1457604910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043238223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E SUPERIOR ST",
"address_2": "SUITE 444",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112654",
"telephone_number": "312-943-0282",
"fax_number": "312-943-0284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E SUPERIOR ST",
"address_2": "SUITE 444",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112654",
"telephone_number": "312-943-0282",
"fax_number": "312-943-0284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELSEY",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "01620273",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.