Individual provider Active NPI

Patrick Francis Kelly, MD

  • Pediatric Hematology & Oncology Physician
  • Cambridge, MA
National Provider Identifier
1306026919
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
35-080592 Issued in OH
Practice address
87 Cambridgepark Dr
Y2010
Cambridge, MA 02140-2311
Phone
(617) 665-7277
Fax
(617) 665-8315
NPI assigned
Nov 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 35-080592 OH Primary

Addresses

Primary practice location

87 Cambridgepark Dr
Y2010
Cambridge, MA 02140-2311

Mailing address

87 Cambridgepark Dr
Y2010
Cambridge, MA 02140-2311
Phone (617) 665-7277

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-080592OHMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1306026919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 CAMBRIDGEPARK DR",
            "address_2": "Y2010",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402311",
            "telephone_number": "617-665-7277",
            "fax_number": "617-665-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 CAMBRIDGEPARK DR",
            "address_2": "Y2010",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402311",
            "telephone_number": "617-665-7277",
            "fax_number": "617-665-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICK",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "OH",
            "license": "35-080592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.