Kelvin A Barry Sr., D.P.M.
Individual provider Active NPI Foot Surgery Podiatrist · West Deptford, NJ
NPI 1225026727 · NPPES record last updated Dec 29, 2023
Key facts
- NPI
- 1225026727
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- 25MD00365600 (NJ)
- Practice address
- 204 Grove Ave Ste G
West Deptford, NJ 08086-2557 - Phone
- (877) 487-3338
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Foot Care Center, LLC
Foot and Ankle Specialty LLC
Practice addresses (Care Compare)
204 Grove Ave
Suite G
West Deptford, NJ 08086-2557
Phone (856) 579-8674
550 Summit Ave
Jersey City, NJ 07306-2707
Phone (201) 721-6827
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 60 |
| Removal of nail tissue | 435 |
| Removal or shaving of skin growth | 119 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240111002723 | NJ | Practitioner - Podiatry | 1456453323 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N006134 | NY | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Foot Care Center, LLC | Primary Podiatric Medicine | Current |
Accepting new patients |
| Suny Downstate Medical Center | Past |
Accepting new patients | |
| The Foot Specialty Practice, P.C. | Foot & Ankle Surgery | Past |
Accepting new patients |
| Rory Cohen DPM PC | Primary Podiatric Medicine | Past | Accepting new patients |
Locations
204 Grove Ave
Ste G
West Deptford, NJ 08086
Phone (856) 579-8674
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 25MD00365600 | NJ | |
| Sports Medicine Podiatrist | 213ES0000X | 25MD00365600 | NJ | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 25MD00365600 | NJ | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | N006134 | NY | |
| Foot Surgery Podiatrist | 213ES0131X | N006134 | NY | |
| Foot Surgery Podiatrist | 213ES0131X | 25MD00365600 | NJ | Yes |
Addresses
Primary practice location
204 Grove Ave Ste G
West Deptford, NJ 08086-2557
Mailing address
204 Grove Ave Ste G
West Deptford, NJ 08086-2557
Phone (877) 487-3338
Other practice location 1
4 Bypass Rd
Salem, NJ 08079-2053
Phone (877) 487-3338
Other practice location 2
704 E Main St Ste C
Moorestown, NJ 08057-3070
Phone (877) 487-3338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N006134 | Other | NY | NEW YORK STATE LICENSE |
| 02882406 | Medicaid | NY | |
| 25MD00365600 | Other | NJ | NEW JERSEY STATE LICENSE |
Other names
- Dr. Kelvin A Barry Sr.
Other providers in West Deptford, NJ
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- Aaron Bess
- Beyond Behaviors Therapy Services
- Braden Dental of South Jersey PC
- Valerie Braunstein
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All providers in West Deptford, NJ · Foot Surgery Podiatrist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.