Trevor Kelly, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26323 Issued in MA

Practice address

85 Main St
Ste 103
Watertown, MA 02472

Phone

(617) 924-5100

Fax

(617) 924-5199

NPI assigned

Aug 18, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Brothers Physical Therapy IncGroup PAC ID 9537118187, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Needham, MA
  • NPI 1982756854
  Medicare reassignment Care Compare group NPD
• Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Watertown, MA
  • NPI 1811063803
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1336867183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 MAIN ST",
            "address_2": "STE 103",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-924-5100",
            "fax_number": "617-924-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MAIN ST",
            "address_2": "STE 103",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-924-5100",
            "fax_number": "617-924-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-03-29",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Anne Keary
• Stephanie Keesey
• Jaclyn Rose Kehoe, LCSW
• Robert P Kelleher, MD
• Naomi M Kelly, CCC SLP
• Kennedy Brothers Physical Therapy Inc.
• Michael P. Kenney, PT
• Kensington Therapeutic, LLC
• Brenda Kerbel
• Richard John Kerbel, M.D.

• Physical Therapist in Watertown, MA
• Providers in Watertown, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.