Individual provider Active NPI

John Joseph Kelly IV, MD

  • Orthopaedic Surgery Physician
  • Orlando, FL
National Provider Identifier
1174150163
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME181916 Issued in FL
Practice address
10155 Dowden Rd Ste 301
Orlando, FL 32832-5227
Phone
(321) 843-5851
Fax
(407) 569-1701
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 79276 MN
Orthopaedic Surgery Physician 207X00000X ME181916 FL Primary

Addresses

Primary practice location

10155 Dowden Rd Ste 301
Orlando, FL 32832-5227

Mailing address

10155 Dowden Rd Ste 301
Orlando, FL 32832-5227
Phone (321) 843-5851

Other practice location 1

1222 S. Orange Avenue
5th FL, MP#43
Orlando, FL 32806
Phone (321) 841-1764

Other practice location 2

200 1st St SW
Rochester, MN 55905-0002
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkelly2519389@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250812001265 MN Practitioner - Sports Medicine 0042718793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Procedures performed for Medicare patients

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79276MNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Sports Medicine Current Accepting new patients
Mayo Clinic CurrentSince Aug 1, 2025 Accepting new patients
Mayo Clinic CurrentSince Aug 1, 2025 Accepting new patients
Orlando Health Medical Group Inc Sports Medicine PastSince Mar 1, 2020 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1174150163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10155 DOWDEN RD STE 301",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325227",
            "telephone_number": "321-843-5851",
            "fax_number": "407-569-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 DOWDEN RD STE 301",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325227",
            "telephone_number": "321-843-5851",
            "fax_number": "407-569-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 S. Orange Avenue",
            "address_2": "5th FL, MP#43",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "32806",
            "country_code": "US",
            "telephone_number": "321-841-1764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050002",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "79276",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME181916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelly2519389@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.