Individual provider Active NPI

Alicia Ann McKelvey, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wynnewood, PA
National Provider Identifier
1306818497
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
042616 Issued in CT
Practice address
100 E Lancaster Ave
Suite 280 Lankenau Med Sci BLDG.
Wynnewood, PA 19096-3450
Phone
(484) 527-0404
Fax
(610) 527-0824
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 042616 CT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD425541 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 042616 CT Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 280 Lankenau Med Sci BLDG.
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 280 Lankenau Med Sci BLDG.
Wynnewood, PA 19096-3450
Phone (484) 527-0404

Other practice location 1

263 Farmington Avenue
Farmington, CT 06030-8082
Phone (860) 679-3343

Other identifiers 1

IdentifierTypeStateIssuer
23-2359401OtherPAMLHC TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20040803001205 CT Practitioner - Thoracic SurgeryPractitioner - General SurgeryPractitioner - Surgical Oncology 9436120482 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042616CTMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Oct 14, 2024 Accepting new patients
American Current Care PA CurrentSince Oct 14, 2024 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Aug 15, 2015 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

701 Main St
East Hartford, CT 06108
Phone (860) 289-5561

85 Seymour St
Ste 409
Hartford, CT 06106
Phone (860) 522-4158

85 Seymour St
Ste 227
Hartford, CT 06106
Phone (860) 545-1888

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1306818497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 280 LANKENAU MED SCI BLDG.",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-527-0404",
            "fax_number": "610-527-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 280 LANKENAU MED SCI BLDG.",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-527-0404",
            "fax_number": "610-527-0824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308082",
            "country_code": "US",
            "telephone_number": "860-679-3343",
            "fax_number": "860-679-4256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "ALICIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "042616",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD425541",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "042616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MLHC TAX ID",
            "identifier": "23-2359401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.