NPIMap

Individual provider Active NPI

Timothy Raymond Kelliher, MD

  • Neurology Physician
  • Beverly, MA
National Provider Identifier
1043314198
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
75613 Issued in MA
Practice address
152 Conant St Ste 200
Beverly, MA 01915-1659
Phone
(978) 922-2226
Fax
(978) 922-2269
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 75613 MA Primary

Addresses

Primary practice location

152 Conant St Ste 200
Beverly, MA 01915-1659

Mailing address

152 Conant St Ste 200
Beverly, MA 01915-1659
Phone (978) 922-2226

Other identifiers 5

IdentifierTypeStateIssuer
722666OtherTUFTS
814325OtherAETNA USHC
DM9771OtherHCHP
J31266OtherBLUE CROSS
A20168MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.kelliher.1@21341.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000053 MA Practitioner - Neurology 4688682750 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Neurology and Emg LLCGroup PAC ID 4183886609, 7 clinicians
Mindspan Medical PCGroup PAC ID 3971099003, 2 clinicians

Practice addresses (Care Compare)

83 Herrick St
Suite 1001
Beverly, MA 01915-2753
Phone (978) 922-2226

99 Conifer Hill Dr
Danvers, MA 01923-1193
Phone (978) 850-3914

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Perry Medical Group of Florida PA CurrentSince Jan 22, 2025 Accepting new patients
North Shore Neurology & Emg LLC Neurology CurrentSince Nov 14, 2011 Accepting new patients
New York Remote Medical PC CurrentSince Dec 31, 2024 Accepting new patients
Mindspan Medical PC CurrentSince Nov 19, 2025 Accepting new patients
Perry Medical Group of New Jersey PA CurrentSince Jan 22, 2025 Accepting new patients
NS Neurology and Emg Neurology PastSince Apr 20, 2025 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. Past Accepting new patients

Locations

83 Herrick St
Ste 1001
Beverly, MA 01915
Phone (978) 921-1900

152 Conant St
Ste 200
Beverly, MA 01915
Phone (978) 922-2226

99 Conifer Hill Dr
Ste 300
Danvers, MA 01923

99 Conifer Hill Dr
Danvers, MA 01923
Phone (978) 774-2555

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21341/brand/1/csg/1/fhir/r4
  • Direct secure messaging: timothy.kelliher.1@33590.direct.athenahealth.com
  • Direct secure messaging: timothy.kelliher.1@21341.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1043314198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 CONANT ST STE 200",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151659",
            "telephone_number": "978-922-2226",
            "fax_number": "978-922-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 CONANT ST STE 200",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151659",
            "telephone_number": "978-922-2226",
            "fax_number": "978-922-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLIHER",
        "first_name": "TIMOTHY",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "75613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "722666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "814325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCHP",
            "identifier": "DM9771",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J31266",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A20168",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.kelliher.1@21341.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "152 Conant St Ste 200",
            "city": "Beverly",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019151659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.