Individual provider Active NPI

Joseph P Kelly, DO

  • Orthopaedic Surgery Physician
  • New Berlin, WI
National Provider Identifier
1164917779
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
81454-21 Issued in WI
Practice address
12555 W National Ave Ste 100
New Berlin, WI 53151-4061
Phone
(262) 395-4141
NPI assigned
Jun 26, 2018
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X O-1746 ID
Orthopaedic Surgery Physician 207X00000X 81454-21 WI Primary

Addresses

Primary practice location

12555 W National Ave Ste 100
New Berlin, WI 53151-4061

Mailing address

12555 W National Ave Ste 100
New Berlin, WI 53151-4061
Phone (262) 395-4141

Other practice location 1

17000 W North Ave Ste 104W
Brookfield, WI 53005-4423
Phone (262) 395-4141

Other practice location 2

8907 S Howell Ave Ste 800
Oak Creek, WI 53154-4461
Phone (262) 395-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20240730003239 WI Practitioner - Orthopedic Surgery 5092173773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Orthopaedic and Rehabilitation Specialists S CGroup PAC ID 8325930480, 11 clinicians

Practice addresses (Care Compare)

12555 W National Ave
Suite 100
New Berlin, WI 53151-4061
Phone (262) 799-5605

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Orthopaedic and Rehabilitation Specialists S C Orthopaedic Surgery CurrentSince Sep 3, 2024 Accepting new patients

Locations

17000 W North Ave
Ste 104W
Brookfield, WI 53005
Phone (262) 395-4141

12555 W National Ave
Ste 100
New Berlin, WI 53151
Phone (262) 395-4141

8907 S Howell Ave
Ste 800
Oak Creek, WI 53154
Phone (262) 395-4141

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1164917779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 W NATIONAL AVE STE 100",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514061",
            "telephone_number": "262-395-4141",
            "fax_number": "262-395-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W NATIONAL AVE STE 100",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514061",
            "telephone_number": "262-395-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17000 W North Ave Ste 104W",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530054423",
            "country_code": "US",
            "telephone_number": "262-395-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8907 S Howell Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531544461",
            "country_code": "US",
            "telephone_number": "262-395-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "O-1746",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "81454-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.