Individual provider Active NPI

Kelley Jannae Halstead, MD

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1063420552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
238568 Issued in NY
Practice address
142 Joralemon St
Suite 4C-F
Brooklyn, NY 11201-4709
Phone
(718) 624-0604
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 238568 NY Primary

Addresses

Primary practice location

142 Joralemon St
Suite 4C-F
Brooklyn, NY 11201-4709

Mailing address

300 Lenox Rd
Apt 2L
Brooklyn, NY 11226-2273
Phone (718) 941-0088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211001398 NY Practitioner - Obstetrics/Gynecology 7315245982 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York Downstate Medical Center, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

  • Brooklyn Hospital Center - Downtown Campus Hospital, Brooklyn, NY, CCN 330056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238568NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Beach OBGYN, P.C. Obstetrics & Gynecology CurrentSince Nov 1, 2020 Accepting new patients
TBHC Physician Services PC Obstetrics & Gynecology CurrentSince Sep 1, 2023 Accepting new patients
Kings Physician Services, PC CurrentSince Mar 16, 2019 Accepting new patients
Best Women'S Medical Care, PC CurrentSince Jul 29, 2023 Accepting new patients
Professional Gynecological Services, PC CurrentSince Oct 27, 2018 Accepting new patients
Kings Physician Services, PC CurrentSince Mar 16, 2019 Accepting new patients
The Brooklyn Hospital Center Past Accepting new patients

Locations

142 Joralemon St
Ste 4C
Brooklyn, NY 11201
Phone (718) 517-2244

14 DeKalb Ave
Fl 2
Brooklyn, NY 11201
Phone (718) 517-2244

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

3047 Brighton 6th St
Ste 1
Brooklyn, NY 11235
Phone (718) 743-7877

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

142 Joralemon St
Ste 4CF
Brooklyn, NY 11201
Phone (718) 624-0604

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: kholstead@pgs.gwaydirect.com
  • Direct secure messaging: kjh9008@direct.nyp.org
  • Direct secure messaging: khalstead19842@prd.direct.tbh.org

Organizations & group practices 7

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 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063420552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LENOX RD",
            "address_2": "APT 2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262273",
            "telephone_number": "718-941-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JORALEMON ST",
            "address_2": "SUITE 4C-F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014709",
            "telephone_number": "718-624-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "KELLEY",
        "middle_name": "JANNAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "238568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.