Individual provider Active NPI

Kelly J Gardner, MD

  • Pediatric Pulmonology Physician
  • Boston, MA
National Provider Identifier
1437562618
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
269950 Issued in MA
Practice address
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone
(617) 726-2687
NPI assigned
Jun 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 269950 MA
Pediatric Sleep Medicine Physician 2080S0012X 269950 MA
Hospitalist Physician 208M00000X 269950 MA
Pediatric Pulmonology Physician 2080P0214X 269950 MA Primary

Addresses

Primary practice location

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114

Mailing address

Massachusetts General Hospital
275 Cambridge St, 5TH Floor
Boston, MA 02114
Phone (617) 726-8707

Other practice location 1

MGfC Pediatric Pulmonary at WDH
789 Central Ave
Dover, NH 03820
Phone (603) 740-2366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170509000171 MA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4284851395 Reassigns benefits to 3 organizations
I20230622002228 NH Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 4284851395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Vermont College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
269950MAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2017 Accepting new patients
General Hospital Corp Current Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients
Elliot Professional Services Hospitalist Past Accepting new patients

Locations

275 Cambridge St
Fl 5
Boston, MA 02114
Phone (617) 724-6915

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1153 Centre St
Ste 4349
Jamaica Plain, MA 02130
Phone (617) 983-4626

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Interoperability endpoints

  • Direct secure messaging: kgardner163306@direct.solutionhealth.org
  • Direct secure messaging: gardner.kelly.mgh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1437562618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "275 CAMBRIDGE ST, 5TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT ST.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MGfC Pediatric Pulmonary at WDH",
            "address_2": "789 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "03820",
            "country_code": "US",
            "telephone_number": "603-740-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "269950",
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "MA",
            "license": "269950",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "269950",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MA",
            "license": "269950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.