Active NPI
Brian Kelly
- Acupuncturist
- Bayside, NY
National Provider Identifier
1285969683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 004042
- Practice address
- 3434 Bell Blvd
Bayside, NY 11361-1730 - Phone
- (347) 857-9699
- NPI assigned
- Oct 3, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 004042 | NY | Primary |
Addresses
Primary practice location
3434 Bell Blvd
Bayside, NY 11361-1730
Mailing address
8230 138TH St Apt 6P
Briarwood, NY 11435-1477
Phone (646) 510-5904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004042 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1285969683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8230 138TH ST APT 6P",
"city": "BRIARWOOD",
"state": "NY",
"postal_code": "114351477",
"telephone_number": "646-510-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 BELL BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113611730",
"telephone_number": "347-857-9699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "004042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.