Individual provider Active NPI

Bart A Kellerman, DPM

  • Podiatrist
  • Reading, MA
National Provider Identifier
1386667327
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1453 Issued in MA
Practice address
161 Ash Street
Reading, MA 01867
Phone
(781) 944-8341
Fax
(781) 944-3021
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1453 MA Primary
Podiatrist 213E00000X 171 NH

Addresses

Primary practice location

161 Ash Street
Reading, MA 01867

Mailing address

161 Ash Street
Reading, MA 01867
Phone (781) 944-8341

Other identifiers 4

IdentifierTypeStateIssuer
708712OtherTUFTS HEALTH CARE
Y70579OtherBLUE CROSS BLUE SHIELD MA
33535OtherHARVARD PILGRIM
0030343OtherNEIGHBORHOOD HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
171NHMDGroup Psychotherapy Psychologist
1453MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1386667327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 ASH STREET",
            "city": "READING",
            "state": "MA",
            "postal_code": "01867",
            "telephone_number": "781-944-8341",
            "fax_number": "781-944-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 ASH STREET",
            "city": "READING",
            "state": "MA",
            "postal_code": "01867",
            "telephone_number": "781-944-8341",
            "fax_number": "781-944-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "BART",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1453",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH CARE",
            "identifier": "708712",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "Y70579",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "33535",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0030343",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.