Hortensia Kelly, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB08441500 Issued in NJ

Practice address

851 Mount Prospect Ave
Newark, NJ 07104-3228

Phone

(973) 481-0501

Fax

(973) 481-0503

NPI assigned

Jul 16, 2008

Last updated

Dec 16, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 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 Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint James Health Inc

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1225409675
  Medicare reassignment NPD
• Nia Medical Center &Spa

  • Clinic/Center
  • Newark, NJ
  • NPI 1619205622
  NPD (past) Authorized official
• Saint James Health, Inc

  • Family Medicine Physician
  • Newark, NJ
  • NPI 1942946736
  NPD

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1114181443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043228",
            "telephone_number": "973-481-0501",
            "fax_number": "973-481-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043228",
            "telephone_number": "973-481-0501",
            "fax_number": "973-481-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "HORTENSIA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08441500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed Zahid Raza Kazmi, MD
• KBF Foot and Ankle Surgeons, PA
• Hawanatu Kebbie
• Thomas Gregory Keeling, D.M.D.
• David B Kelly III, MD
• Margaret Kelly, LCSW
• Sophia Kelly
• Susan E Kelly, FNP
• Denise Kemp, CRNA, MS
• Marin Machaela Kempel, PA

• Family Medicine Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.