Russell Aaron Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1762 Issued in MA

Practice address

451 Andover St Ste 206a
North Andover, MA 01845-5044

Phone

(978) 662-1002

Fax

(978) 767-4757

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Care Clinic LLCGroup PAC ID 8325579592, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Core Care Clinic LLC

  • Internal Medicine Physician
  • North Andover, MA
  • NPI 1316784457

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  MA

  Medicare reassignment NPD
• North Shore Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Beverly, MA
  • NPI 1164739306
  Medicare reassignment
• Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
  • NPI 1780115519
  Medicare reassignment
• North Shore Pain Management

  • Durable Medical Equipment & Medical Supplies
  • Beverly, MA
  • NPI 1992187041
  NPD
• Inpatient Consultants of Massachusetts, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1093148926

  Physician Assistant

  NPD (past)

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

• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1043316532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LAKEWOOD RD",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019401945",
            "telephone_number": "817-249-6671",
            "fax_number": "978-767-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 ANDOVER ST STE 206A",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455044",
            "telephone_number": "978-662-1002",
            "fax_number": "978-767-4757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Lexington St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Waltham",
            "state": "MA",
            "postal_code": "024524401",
            "country_code": "US",
            "telephone_number": "978-662-1002",
            "fax_number": "978-767-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RUSSELL",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111477",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0009706",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Suzanne Keeler, MS, CCC/SLP
• Tracy Anne Keen
• Amy Kehoe, LMHC
• Robyn E Keleher, MSW, LICSW
• Heidi Laura Kelleher, PMHNP-BC
• Sandra Lucille Kelsey, P.T.
• Jessica P Kenney, OTR/L
• Rebeka Keuten, PNP
• Evgenia Khemlin, NP
• Kids Dr. PC

• Physician Assistant in North Andover, MA
• Providers in North Andover, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.