Christine Kelleher

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

432740 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-2000

NPI assigned

Feb 26, 2024

Sex

Female

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: ckelleher38386@mskcc.direct-ci.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.

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1104682285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ALPHA CT",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482801",
            "telephone_number": "732-957-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles B. Kellam, LCSW-R
• Tavoria Kellam, MW
• Lucia Kellar, PH.D.
• Andrew Kelleher, MD
• Catherine Kelleher
• Deirdre Clare Kelleher, M.D.
• Mary Kelleher
• Sarah Kelleher, LCSW
• Stephanie Lea Kelleher, LCSW-R
• Bonnie Gaer Kellen, PH.D.

• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.