Individual provider Active NPI

Catherine Kelly, DO

  • Emergency Medicine Physician
  • West Islip, NY
National Provider Identifier
1174871255
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
279380 Issued in NY
Practice address
1000 Montauk Hwy
West Islip, NY 11795
Phone
(631) 376-4444
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 279380 NY Primary

Addresses

Primary practice location

1000 Montauk Hwy
West Islip, NY 11795

Mailing address

360 Maple Ave
Box 119
Westbury, NY 11590-7500
Phone (914) 224-3884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161102002836 NY Practitioner - Emergency Medicine 1850679366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians

Practice addresses (Care Compare)

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279380NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Post Road Medical Services PC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince May 22, 2018 Accepting new patients

Locations

99 Business Park Dr
Armonk, NY 10504
Phone (914) 219-8515

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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 1

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": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1174871255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MAPLE AVE",
            "address_2": "BOX 119",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115907500",
            "telephone_number": "914-224-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "11795",
            "telephone_number": "631-376-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "279380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.