Active NPI
Raymond Joseph Kelly, PA-C
- Physician Assistant
- East Hills, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 022111
- Practice address
- 2200 Northern Blvd Ste 121
East Hills, NY 11548-1220 - Phone
- (516) 705-1044
- NPI assigned
- Jun 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 022111 | NY | Primary |
Addresses
Primary practice location
2200 Northern Blvd Ste 121
East Hills, NY 11548-1220
Mailing address
401 S 8TH St
Lindenhurst, NY 11757-4614
Phone (631) 805-1462
Other practice location 1
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6000
Other practice location 2
260 E 66th St Fl 1
New York, NY 10065-9196
Phone (646) 293-7500
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 325-7520
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022111 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Orthopaedic & Neurosurgery Specialists, PLLC | Current | Accepting new patients | |
| CHS Physician Partners, P.C | Current | Accepting new patients | |
| Orthopaedic & Neurosurgery Specialists, PLLC | Physician Assistant | Current | Accepting new patients |
| Summit Medical Group PA | Past | Accepting new patients | |
| City Medical of Upper East Side, PLLC | Past | Accepting new patients |
Locations
600 Northern Blvd
Ste 300
Great Neck, NY 11021
Phone (516) 627-8717
2200 Northern Blvd
Ste 121
Greenvale, NY 11548
Phone (516) 705-1044
500 Mamaroneck Ave
Harrison, NY 10528
Phone (203) 869-1145
245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141
260 E 66th St
Fl 1
New York, NY 10065
Phone (646) 293-7500
1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012
100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800
100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- rkelly283388@nyumc.direct-ci.com
- rkelly69978@northwell.direct-ci.com
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- West Islip, NY
- NPI 1124184544
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY
-
- Orthopaedic Surgery Physician
- Greenwich, CT
- NPI 1033318720
NY, Physician Assistant
-
dba Cardiac Interventional Group
- Interventional Cardiology Physician
- Fresh Meadows, NY
- NPI 1407089345
-
- Cardiovascular Disease Physician
- Roslyn, NY
- NPI 1164585725
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Orthopaedic Surgery Physician
- Newington, CT
- NPI 1043086531
-
dba Citymd
- Multi-Specialty Clinic/Center
- Huntington, NY
- NPI 1043815848
-
- Multi-Specialty Clinic/Center
- Berkeley Heights, NJ
- NPI 1942254347
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Roslyn, NY
- NPI 1043279565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1376038695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S 8TH ST",
"city": "LINDENHURST",
"state": "NY",
"postal_code": "117574614",
"telephone_number": "631-805-1462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 NORTHERN BLVD STE 121",
"city": "EAST HILLS",
"state": "NY",
"postal_code": "115481220",
"telephone_number": "516-705-1044"
}
],
"practiceLocations": [
{
"address_1": "100 Port Washington Blvd",
"address_purpose": "LOCATION",
"city": "Roslyn",
"state": "NY",
"postal_code": "115761347",
"country_code": "US",
"telephone_number": "516-562-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "260 E 66th St Fl 1",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100659196",
"country_code": "US",
"telephone_number": "646-293-7500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "RAYMOND",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-28",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "022111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.