Kelly O'Donnell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00288700 Issued in NJ

Practice address

385 Morris Ave FL 2
Springfield, NJ 07081-1151

Phone

(973) 329-2111

Fax

(973) 379-2807

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
• Overlook Medical Center Hospital, Summit, NJ, CCN 310051
• Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group
• Ipc Hospitalist Physicians of New Jersey PC

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1639303159

  Physician Assistant

  Medicare reassignment NPD
• Ahs Hospital Corp

  • Clinical Medical Laboratory
  • Morristown, NJ
  • NPI 1871162834
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp

  • General Acute Care Hospital
  • Hackettstown, NJ
  • NPI 1518969419
  Care Compare affiliation
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  Care Compare affiliation

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1447500319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MORRIS AVE FL 2",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811151",
            "telephone_number": "973-329-2111",
            "fax_number": "973-379-2807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "741 Northfield Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070521104",
            "country_code": "US",
            "telephone_number": "973-379-2111",
            "fax_number": "973-379-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Mount Hope Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Rockaway",
            "state": "NJ",
            "postal_code": "078661656",
            "country_code": "US",
            "telephone_number": "973-379-2111",
            "fax_number": "973-379-2807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00288700",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00288700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey M Notis, MD
• Helen L Nunez, MD
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• Alicia Ellen O'Connor, LCSW
• Ilyse O'Desky, PSY.D.
• Mary Odusanya
• Funmilayo A Ogunruku, APN
• Ilanit Ohayon, SCHOOL PSYCHOLOGIST
• Ohi of Puerto Rico, LLC
• Ejiroghene Okopie

• Physician Assistant in Springfield, NJ
• Providers in Springfield, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.