Theresa Kelly, PT, DPT, MS ED

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00538500 Issued in NJ

Practice address

800 E Gate Blvd
Garden City, NY 11530-2105

Phone

(973) 332-1377

NPI assigned

Jun 11, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Metro Physical Therapy LLC

  • Physical Therapist
  • Garden City, NY
  • NPI 1144028796

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1104711951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OAKLEY WAY",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703015",
            "telephone_number": "973-332-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E GATE BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302105",
            "telephone_number": "973-332-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MS ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "40QA00538500",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00538500",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA00538500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Ann Kelly, M.D.
• Kaitlyn Eileen Kelly
• Mandy A Kelly, MSED
• Patricia Kelly, LPN
• Tara Kelly
• Matthew Kelpaire, PT,DPT
• Beth Ann Kendrick, CCC-SLP
• Kenya Crafton NP Family Health PLLC
• Kathleen Kerr
• Taylor Kerrane

• Physical Therapist in Garden City, NY
• Providers in Garden City, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.