Lawrence P Kelly, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

152310 Issued in NY

Practice address

25270 Main Rd
Cutchogue, NY 11935-1286

Phone

(631) 734-7184

Fax

(631) 734-7186

NPI assigned

Aug 8, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1073523544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119350743",
            "telephone_number": "631-734-7184",
            "fax_number": "631-734-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25270 MAIN RD",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119351286",
            "telephone_number": "631-734-7184",
            "fax_number": "631-734-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAWRENCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "152310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Patrice Gillette, LCSW
• Betsy Dale Goodman-Bitman, CCC, SLP
• Diane Elaine Harned, LPN
• Angelica Horlocher, RPH
• Lizbeth Jansen, DPT
• King Kullen Pharmacies Corp
• Lynn W Leaden, MA, CCC-LSP
• Taylor Michelle Leden
• Hannah Lewis, L.AC., MSTOM
• Long Island Massage, PLLC

• Surgery Physician in Cutchogue, NY
• Providers in Cutchogue, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.