NPIMap

Individual provider Active NPI

Luz Milagros Kelly, NP

  • Family Nurse Practitioner
  • Rensselaer, NY
National Provider Identifier
1164154803
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350197 Issued in NY
Practice address
279 Troy Rd
Rensselaer, NY 12144-9518
Phone
(518) 286-1922
Fax
(518) 283-3225
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11019185 FL
Family Nurse Practitioner 363LF0000X 350197 NY Primary

Addresses

Primary practice location

279 Troy Rd
Rensselaer, NY 12144-9518

Mailing address

PO Box 14890
Albany, NY 12212-4890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230109000075 NY Practitioner - Nurse Practitioner 2860862802 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

279 Troy Rd
Rensselaer, NY 12144-9756
Phone (518) 286-1922

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
350197NYMDLicensed Practical Nurse
11019185FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Jan 2, 2023 Accepting new patients
Saratoga Hospital CurrentSince Apr 8, 2024 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Apr 28, 2024 Accepting new patients
Kellys Family Healthcare NP in Family Health PLLC Family CurrentSince May 17, 2026 Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Apr 8, 2024 Accepting new patients
Saratoga Regional Medical , P.C Current Accepting new patients
Scotia Glenville Family Medicine, P.C. Current Accepting new patients
Saratoga Hospital CurrentSince Apr 8, 2024 Accepting new patients
Saratoga Hospital CurrentSince Apr 8, 2024 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Apr 28, 2024 Accepting new patients
Saratoga Hospital Current Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Jan 2, 2023 Accepting new patients

Locations

510 Geyser Rd
Ballston Spa, NY 12020
Phone (518) 289-2720

112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

279 Troy Rd
Rensselaer, NY 12144
Phone (518) 286-1922

24 Hamilton St
Saratoga Springs, NY 12866
Phone (518) 886-5600

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

15 Maple Dell
Ste 1
Saratoga Springs, NY 12866
Phone (518) 583-7400

1111 Hudson Ave
Stillwater, NY 12170
Phone (518) 664-3242

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: lkelly2295186@direct.trinity-health.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1164154803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 TROY RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449518",
            "telephone_number": "518-286-1922",
            "fax_number": "518-283-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LUZ",
        "middle_name": "MILAGROS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11019185",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "279 Troy Rd",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121449518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.