Paul Mitchell Kelleher, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

206597 Issued in NY

Practice address

49 W Rayburn Rd
Millington, NJ 07946-1502

Phone

(908) 542-1792

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moretti and Racco Medical Associates, PCGroup PAC ID 0840216669, 4 clinicians

Atlantic Physical Medicine and Rehabilitation Center P aGroup PAC ID 4981678455, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkelleher59290@epicdirect.rwjbh.org

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.

• Atlantic Physical Medicine & Rehabilitation Center P a

  • Physical Medicine & Rehabilitation Physician
  • Toms River, NJ
  • NPI 1568436111
  Medicare reassignment Care Compare group NPD
• Paul Mitchell Kelleher DO LLC

  • Physical Medicine & Rehabilitation Physician
  • Millington, NJ
  • NPI 1871831669
  Medicare reassignment NPD Authorized official
• Moretti & Racco Medical Associates PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1548286081

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Paul Mitchell Kelleher

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Staten Island, NY
  • NPI 1598966244
  NPD (past) Authorized official
• Atlantic Rehabilitation Medicine Associates PA

  • Physical Medicine & Rehabilitation Physician
  • Windermere, FL
  • NPI 1194006981
  NPD
• NYU Lutheran Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1538111653
  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1326052473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 W RAYBURN RD",
            "city": "MILLINGTON",
            "state": "NJ",
            "postal_code": "079461502",
            "telephone_number": "908-542-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 W RAYBURN RD",
            "city": "MILLINGTON",
            "state": "NJ",
            "postal_code": "079461502",
            "telephone_number": "908-542-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "PAUL",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB06963200",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "206597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02057174",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malathi Buddhi, DMD
• Danielle Cicalese
• Monica Dos Santos, OTR
• Adriana Giraldo, M.ED, BCBA
• Home Roots Safety Solutions
• Dana Angela Loria
• Jessica Lynn Lukaszek, OTR
• Our House, Inc.
• Paul Mitchell Kelleher DO LLC
• Yardena Raban, HEALTH COACH

• Physical Medicine & Rehabilitation Physician in Millington, NJ
• Providers in Millington, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.