John V. Kelly MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JOHN V. KELLY MD, PC

Practice address

382 W Passaic Ave
Bloomfield, NJ 07003-5552

Phone

(973) 338-1900

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

John Kelly, MDNPI 1265540686

Title

President

Phone

(973) 338-1900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Kelly, MD

  • Internal Medicine Physician
  • Bloomfield, NJ
  • NPI 1265540686
  Medicare reassignment Care Compare group NPD Authorized official
• Geraldine Calixte-Starks, FNP-C

  • Family Nurse Practitioner
  • Orange, NJ
  • NPI 1497562516
  Medicare reassignment Care Compare group NPD
• Elyse Fearon

  • Gerontology Nurse Practitioner
  • Bloomfield, NJ
  • NPI 1720896491
  Medicare reassignment Care Compare group NPD
• Natalie Rose Graziano, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Bloomfield, NJ
  • NPI 1891402376
  Medicare reassignment Care Compare group NPD
• Jessy Samuel, FNP

  • Family Nurse Practitioner
  • Paterson, NJ
  • NPI 1154940450
  Medicare reassignment Care Compare group NPD
• Scott Carmine Masullo Sr., NP

  • Family Nurse Practitioner
  • Bloomfield, NJ
  • NPI 1568189322
  Medicare reassignment NPD
• John M Andreoni, MD

  • Infectious Disease Physician
  • Palos Heights, IL
  • NPI 1225024508
  NPD (past)
• Seshank Arimilli

  • Infectious Disease Physician
  • Maywood, IL
  • NPI 1053773044
  NPD (past)
• Jennifer M Bassler

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1992213896
  NPD (past)
• Godofredo C Carandang, MD

  • Infectious Disease Physician
  • Palos Heights, IL
  • NPI 1346235934
  NPD (past)
• Ankur B Dave, D.O

  • Infectious Disease Physician
  • Palos Heights, IL
  • NPI 1225327919
  NPD (past)
• Kiran Dhillon, M.D.

  • Infectious Disease Physician
  • Palos Heights, IL
  • NPI 1053383125
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417065830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035552",
            "telephone_number": "973-338-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035552",
            "telephone_number": "973-338-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V. KELLY MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-338-1900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Jimenez, COTA
• JLF Counseling, LLC
• JMP, LLC
• Shirley Joanis, MED
• Job Haines Home for Aged People
• Sharonda S Johnson, LPC
• Jones Inspirations Counseling
• Suja K Jose, PT
• Deborah Josefson, MD
• Joseph Distefano, DMD, PC

• Internal Medicine Physician in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.