Samuel Kelly, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD494843 Issued in PA

Practice address

1101 Chestnut St FL 9
Philadelphia, PA 19107-3612

Phone

(215) 955-5050

Fax

(215) 955-5050

NPI assigned

Mar 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: skelly91436@direct.phhs.org

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1265991442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD494843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKayla Frances Kelly, ATS
• Megan Kelly, C.R.N.P.
• Meronda Kelly
• Patricia Kelly
• Rebecca Katherine Kelly, MD
• Sarah Kelly, MD
• Sarah Kelly, LPC
• Shareen F. Kelly, M.D.
• Stacey Elizabeth Kelly
• Susan Schack Kelly, PHD

• Cardiovascular Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.