Michael John Kelleher, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

D40516 Issued in MD

Practice address

106 Milford Street
Suite 101
Salisbury, MD 21804

Phone

(410) 742-1567

Fax

(410) 742-1906

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Merit-based Incentive Payment System (MIPS)

Final score

90.25 of 100Reported as group

Quality

93.38

Improvement activities

40

Cost

76.32

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEHCBA

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.

• Eastern Shore ENT & Allergy

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Salisbury, MD
  • NPI 1154308021
  Medicare reassignment NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1417046004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD STREET",
            "address_2": "SUITE 101",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-742-1567",
            "fax_number": "410-742-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD STREET",
            "address_2": "SUITE 101",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-742-1567",
            "fax_number": "410-742-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D40516",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MD",
            "license": "D40516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091591200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Elaine Keidel
• Judianne Keightly, CRNP
• Stephen George Keim, M.D.
• Jennifer Keithly, PHYSICIAN ASSISTANT
• Heather Lynne Kellam, LCSWC
• Daniel Joseph Kelley, MD
• Laura Mayer Kelley, MD
• Krista Helen Kelly-Hearn
• Amanda Kelly
• Cynthia A Kelly, CRNA

• Otolaryngology Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Otolaryngology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.

Verify at the official NPI Registry.