NPIMap

Individual provider Active NPI

Kelley James Brossy, D.O.

  • Orthopaedic Surgery Physician
  • Dearborn, MI
National Provider Identifier
1235423708
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101019337 Issued in MI
Practice address
21031 Michigan Ave
Dearborn, MI 48124-2339
Phone
(313) 277-6700
Fax
(313) 277-2483
NPI assigned
Jun 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101019337 MI Primary

Addresses

Primary practice location

21031 Michigan Ave
Dearborn, MI 48124-2339

Mailing address

21243 Robinwood St
Farmington, MI 48336-5081
Phone (909) 563-0906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160615002686 CA Practitioner - Orthopedic Surgery 9739470105 Reassigns benefits to 1 organization
I20170926003840 MI Practitioner - Orthopedic Surgery 9739470105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelley Brossy DO PCGroup PAC ID 3173897469, 2 clinicians
Dearborn Physical Therapy LTDGroup PAC ID 2668383910, shared by 2 NPIs, 97 clinicians

Practice addresses (Care Compare)

21031 Michigan Ave
Dearborn, MI 48124-2339
Phone 3132776700316

23852 Michigan Ave
Dearborn, MI 48124-1829

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019337MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelley Brossy DO PC CurrentSince Aug 28, 2017 Accepting new patients
McLaren Oakland CurrentSince Jun 15, 2019 Accepting new patients
Michigan Orthopedic Specialists, PC Orthopaedic Surgery CurrentSince Nov 1, 2023 Accepting new patients
McLaren Oakland CurrentSince Jun 15, 2019 Accepting new patients
Orthopedic Trauma Surgeons of Northern California CurrentSince Aug 1, 2018 Accepting new patients
Brossy-Waterworks PC Orthopaedic Surgery PastSince Jan 7, 2020 Accepting new patients

Locations

6620 Coyle Ave
Ste 212
Carmichael, CA 95608
Phone (916) 536-9455

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

21031 Michigan Ave
Dearborn, MI 48124
Phone (313) 216-0332

28080 Grand River Ave
Ste 207
Farmington Hills, MI 48336
Phone (248) 471-8829

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Interoperability endpoints

  • Direct secure messaging: drkbrossy2@direct.miortho.com
  • Direct secure messaging: kbrossy1118961@direct.hfhs.org

Organizations & group practices 6

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 11

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1235423708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21243 ROBINWOOD ST",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483365081",
            "telephone_number": "909-563-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242339",
            "telephone_number": "313-277-6700",
            "fax_number": "313-277-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSY",
        "first_name": "KELLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101019337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.