David B Kelly III, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA11136800 Issued in NJ

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7471

Fax

(973) 926-6452

NPI assigned

Apr 24, 2018

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkelly192532@epicdirect.rwjbh.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment NPD
• Barron Emergency Physicians LLC

  • Emergency Medicine Physician
  • Manahawkin, NJ
  • NPI 1790736940
  Medicare reassignment NPD
• Rwjbh Emergency Medicine Associates, LLC

  • Emergency Medicine Physician
  • Somerset, NJ
  • NPI 1912510041
  Medicare reassignment NPD
• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806
  Medicare reassignment NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1104314236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7471",
            "fax_number": "973-926-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7471",
            "fax_number": "973-926-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA11136800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farid Hasan Kazi, DMD
• Syed Zahid Raza Kazmi, MD
• KBF Foot and Ankle Surgeons, PA
• Hawanatu Kebbie
• Thomas Gregory Keeling, D.M.D.
• Hortensia Kelly, D.O
• Margaret Kelly, LCSW
• Sophia Kelly
• Susan E Kelly, FNP
• Denise Kemp, CRNA, MS

• Pediatrics Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.