Roy A Kellerman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23862 Issued in CT

Practice address

35 Jolley Dr Ste 201
Bloomfield, CT 06002-4228

Phone

(860) 243-5569

Fax

(860) 243-2622

NPI assigned

Nov 27, 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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Internal Medicine

Education

State University of New York at Buffalo School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
• John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036
• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roy.kellerman.1@31837.direct.athenahealth.com

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.

• Roy a. Kellerman, MD, LLC

  • Internal Medicine Physician
  • Bloomfield, CT
  • NPI 1336314475
  Medicare reassignment NPD
• Woodland Anesthesia Associates PC

  • Anesthesiology Physician
  • Hartford, CT
  • NPI 1437109824
  NPD (past)

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

• Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
  • NPI 1073529566
  Care Compare affiliation
• John Dempsey Hospital at Solnit - South Campus

  • Psychiatric Hospital Unit
  • Middletown, CT
  • NPI 1154263713
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation
• State of Connecticut

  • General Acute Care Hospital
  • Farmington, CT
  • NPI 1669466561
  Care Compare affiliation

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1083780605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JOLLEY DR STE 201",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060024228",
            "telephone_number": "860-243-5569",
            "fax_number": "860-243-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JOLLEY DR STE 201",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060024228",
            "telephone_number": "860-243-5569",
            "fax_number": "860-243-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "ROY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "23862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "73169936",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "010023862CT05",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001238625",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkellerman40342@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "35 Jolley Dr Ste 201",
            "city": "Bloomfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060024228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott Michael Kallor, D.O.
• Jina Kang, PHARM.D.
• Alona Kantorovich, MD
• Joan Marie Karpuk, P.T.
• Herbert J Keating III, MD
• Taylor Kelley
• Krystal Kelly, LPC
• Evan Kennedy, PT
• Maham Khan, RPH
• Rebecca L Kilpatrick, APRN

• Internal Medicine Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.