Paul F Kelly, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

28299 Issued in MA

Practice address

3 Woodland Rd
Suite 216
Stoneham, MA 02180-1702

Phone

(781) 979-0661

Fax

(781) 979-0372

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mystic Valley Urological Associates Inc.

  • Urology Physician
  • Stoneham, MA
  • NPI 1740295575
  NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1437184454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PAUL",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "28299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M07461",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161373",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "340005508",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aarti Kakkar, MD
• Sameer O. Kapasi, M.D.
• Angela Karogiannis, M.D.
• Kathleen Perkins, DMD, LLC
• Kristin Kazzi, PA-C
• Sandra Mackay Kelly, NP
• Brent Kersanske
• Irene Khadondi, LPN
• Farrokh Khajavi-Noori, MD
• Racheal Kibuka

• Urology Physician in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Urology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.