John E Kelly, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43538 Issued in MA

Practice address

250 Hampton St
Auburn, MA 01501-2584

Phone

(508) 753-2060

Fax

(508) 752-4244

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MA

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 Medicine

Practice roles

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.

• Grove Medical Associates, PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Auburn, MA
  • NPI 1790716199

  MA

  Medicare reassignment
• Saint Vincent Radiological Associates Inc

  • Diagnostic Radiology Physician
  • Worcester, MA
  • NPI 1366482093

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1174599211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HAMPTON ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012584",
            "telephone_number": "508-753-2060",
            "fax_number": "508-752-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HAMPTON ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012584",
            "telephone_number": "508-753-2060",
            "fax_number": "508-752-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "43538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "190882",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON HEALTH INS #",
            "identifier": "4406",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM ID #",
            "identifier": "64109",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH ID #",
            "identifier": "99995302",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID #",
            "identifier": "N01871",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "710456",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110000875A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eunice Karue, LPN
• Johnson Karue, RN
• Douglas Kay
• Peter M Keefe, MD
• Michael S Kelfer, MD
• Zachary Kelly, PT, DPT
• Megan Kennedy, DPT
• Rebecca L Kesman, MD
• Laura V Kidman, PT
• Kincasa Recovery Centers LLC

• All providers in Auburn, MA
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.