Kelly and Velazquez Eye Center PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

41270 Issued in MA

Legal business name

KELLY AND VELAZQUEZ EYE CENTER PC

Practice address

1504 N Main St
Palmer, MA 01069-1215

Phone

(413) 283-3511

Fax

(413) 283-5396

NPI assigned

Aug 10, 2005

Organization subpart

No

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

Authorized official

Name

Peter J KellyNPI 1649271883

Title

President

Phone

(413) 284-4481

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

Enrollment records 2

Tax ID family

Peter J Kelly MD PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kelly and Velazquez Eye Center PC

  • Durable Medical Equipment & Medical Supplies
  • Ludlow, MA
  • NPI 1063558070
  NPD tax ID
• Kelly and Velazquez Eye Center PC

  • Durable Medical Equipment & Medical Supplies
  • Palmer, MA
  • NPI 1790821197
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter J Kelly, MD

  • Ophthalmology Physician
  • Palmer, MA
  • NPI 1649271883
  Medicare reassignment Care Compare group NPD Authorized official
• Dennis M Dorans, OD

  • Optometrist
  • Palmer, MA
  • NPI 1699776773
  Medicare reassignment Care Compare group NPD
• Kelly Nicole Pouliot, OD

  • Optometrist
  • Palmer, MA
  • NPI 1437843398
  Medicare reassignment Care Compare group NPD
• Leonardo Javier Velazquez, M.D.

  • Ophthalmology Physician
  • Palmer, MA
  • NPI 1396731097
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1306847462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 N MAIN ST",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691215",
            "telephone_number": "413-283-3511",
            "fax_number": "413-283-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N MAIN ST",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691215",
            "telephone_number": "413-283-3511",
            "fax_number": "413-283-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY AND VELAZQUEZ EYE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-284-4481"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "41270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ANCILLARY",
            "identifier": "W20291",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M13919",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNE",
            "identifier": "13541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHPLAN",
            "identifier": "735819",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9739319",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON HEALTHPLAN",
            "identifier": "14520",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C13251",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirby N Juengst, MD
• Richard M Kane, M.D.
• Kirtikant P Kantesaria, MD
• Hannah Karalash, AS
• David S Katz, MD FACS
• Kelly and Velazquez Eye Center PC
• Peter J Kelly, MD
• Kathleen Mary Keough, LICSW
• Mohammad A Khan, MD
• Imad M Khreim, MD

• Ophthalmology Physician in Palmer, MA
• Providers in Palmer, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.