Individual provider Active NPI

Kelly L Delahunty, MD

  • Pediatrics Physician
  • Hudson, WI
National Provider Identifier
1225018229
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
51054 Issued in WI
Practice address
2651 Hillcrest Drive
Hudson, WI 54016-4439
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Jan 18, 2006
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 51054 WI Primary
Pediatrics Physician 208000000X 40456 MN

Addresses

Primary practice location

2651 Hillcrest Drive
Hudson, WI 54016-4439

Mailing address

2651 Hillcrest Drive
Suite 303
Hudson, WI 54016-4439
Phone (715) 531-6800

Other identifiers 2

IdentifierTypeStateIssuer
K400289029OtherWIMEDICARE
271819700MedicaidMN

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
I20160418000504 WI Practitioner - Pediatric Medicine 8820177934 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40456MNMDPediatrics Physician
51054WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Physicians, S.C. CurrentSince Apr 1, 2016 Accepting new patients
Hudson Physicians, S.C. Current Accepting new patients

Locations

840 Spruce St
Baldwin, WI 54002
Phone (715) 235-4274

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

2651 Hillcrest Dr
Ste 303
Hudson, WI 54016

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1225018229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAHUNTY",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "51054",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "40456",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K400289029",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271819700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.