Individual provider Active NPI

Kelley Groves

  • Pediatric Critical Care Medicine Physician
  • New York, NY
National Provider Identifier
1356737373
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
310981 Issued in NY
Practice address
424 E 34TH St FL Street9
New York, NY 10016-4901
Phone
(212) 263-2377
Fax
(212) 263-4985
NPI assigned
Apr 7, 2015
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.133074 OH
Pediatric Critical Care Medicine Physician 2080P0203X 310981 NY Primary

Addresses

Primary practice location

424 E 34TH St FL Street9
New York, NY 10016-4901

Mailing address

424 E 34TH St FL Street9
New York, NY 10016-4901
Phone (212) 263-2377

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgroves456361@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210708000969 NY Practitioner - Pediatric Medicine 1658653241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.133074OHMDPediatrics Physician
310981NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 19, 2021 Accepting new patients
New York University Pediatrics CurrentSince Jul 19, 2021 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kgroves1706019@nychhc.direct-ci.com
  • Direct secure messaging: kgroves456361@nyumc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1356737373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 E 34TH ST FL STREET9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164901",
            "telephone_number": "212-263-2377",
            "fax_number": "212-263-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E 34TH ST FL STREET9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164901",
            "telephone_number": "212-263-2377",
            "fax_number": "212-263-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.133074",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "310981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgroves456361@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "424 E 34th St Fl Street9",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100164901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.