NPIMap

Sean Patrick Kelly, PA-C

Individual provider Active NPI Orthopaedic Surgery of the Spine Physician · Dedham, MA

NPI 1346973880 · NPPES record last updated Jan 30, 2024

Key facts

NPI
1346973880
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery of the Spine Physician 207XS0117X
License
PA8808 (MA)
Practice address
40 Allied Dr
Dedham, MA 02026-6146
Phone
(617) 264-1100
NPI assigned
Jul 1, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 22

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Orthopaedic Alliance PLLC (288 clinicians)

Practice addresses (Care Compare)

125 Parker Hill Ave
Boston, MA 02120-2847
Phone (617) 264-1100

150 Flanders Rd
Westborough, MA 01581-1017
Phone (781) 890-2133

800 W Cummings Park
Suite 2250
Woburn, MA 01801-7034
Phone (781) 890-2133

Hospital & facility affiliations

  • New England Baptist Hospital Hospital · Boston, MA · CCN 220088
  • Emerson Hospital - Hospital · W Concord, MA · CCN 220084
  • Brigham and Women'S Hospital Hospital · Boston, MA · CCN 220110
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility · Charlestown, MA · CCN 223034

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221024001662 MA Practitioner - Physician Assistant 5597131102 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Sports & Shoulder Center, LLC Current
since Oct 1, 2022		 Accepting new patients
Northeast Orthopaedic Alliance PLLC Current
since Mar 1, 2024		 Accepting new patients
Boston Sports & Shoulder Center, LLC Current
since Oct 1, 2022		 Accepting new patients

Locations

830 Boylston St
Ste 107
Chestnut Hill, MA 02467
Phone (617) 264-1100

40 Allied Dr
Dedham, MA 02026
Phone (617) 264-1100

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

840 Winter St
Waltham, MA 02451
Phone (781) 487-9944

71 Border Rd
Ste 300
Waltham, MA 02451
Phone (781) 890-2133

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

Interoperability endpoints

  • Direct secure messaging: sean.kelly.2@749.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/749/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X PA8808 MA Yes

Addresses

Primary practice location

40 Allied Dr
Dedham, MA 02026-6146

Mailing address

10 Calvin Rd
North Easton, MA 02356-1002
Phone (508) 631-5199

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 30, 2024.

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1346973880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CALVIN RD",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561002",
            "telephone_number": "508-631-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ALLIED DR",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266146",
            "telephone_number": "617-264-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MA",
            "license": "PA8808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

All providers in Dedham, MA · Orthopaedic Surgery of the Spine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.