Individual provider Active NPI

Brian Joseph Kelley, M.D.

  • Neurological Surgery Physician
  • Farmington, CT
National Provider Identifier
1114192226
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
070803 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-4319
Phone
(860) 679-8080
Fax
(860) 679-1430
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD454095 PA
Neurological Surgery Physician 207T00000X 070803 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-4319

Mailing address

263 Farmington Ave
Farmington, CT 06030-8082
Phone (860) 679-8080

Other practice location 1

3401 Civic Center Blvd
Division of Neurosurgery
Philadelphia, PA 19104-4319
Phone (215) 590-2780

Other practice location 2

65 Kane Street
West Hartford, CT 06119
Phone (860) 679-8080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkelley60781@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160329001129 PA Practitioner - Neurosurgery 0143527648 Reassigns benefits to 1 organization
I20221028000565 CT Practitioner - Neurosurgery 0143527648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Virginia Commonwealth Univ School of Dentistry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

  • John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD454095PAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Connecticut Health Center CurrentSince Aug 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients
University of Connecticut Health Center CurrentSince Aug 1, 2022 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

65 Kane St
West Hartfrd, CT 06119
Phone (860) 523-6421

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

Interoperability endpoints

  • Direct secure messaging: bkelley60781@direct.med.uchc.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1114192226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060304319",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_2": "Division of Neurosurgery",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-2780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 Kane Street",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "06119",
            "country_code": "US",
            "telephone_number": "860-679-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD454095",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "070803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkelley60781@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "65 Kane Street",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.