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

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.

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 (3 clinicians)
Foot and Ankle Specialty LLC (4 clinicians)

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

ProcedureNumber of procedures
Removal of tissue60
Removal of nail tissue435
Removal or shaving of skin growth119

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 IDStateProvider typePAC IDDetails
I20240111002723 NJ Practitioner - Podiatry 1456453323 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
N006134NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Foot Care Center, LLC Primary Podiatric Medicine Current
since Dec 6, 2023
Accepting new patients
Suny Downstate Medical Center Past
since May 1, 2016
Accepting new patients
The Foot Specialty Practice, P.C. Foot & Ankle Surgery Past
since Mar 7, 2009
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
N006134OtherNYNEW YORK STATE LICENSE
02882406MedicaidNY
25MD00365600OtherNJNEW JERSEY STATE LICENSE

Other names

  • Dr. Kelvin A Barry Sr. Professional name

Other providers in West Deptford, NJ

All providers in West Deptford, NJ · Foot Surgery Podiatrist in New Jersey

Sources for this page

Verify at the official NPI Registry.