Individual provider Active NPI

Kevin Michael McElligott, M.D.

  • Cardiovascular Disease Physician
  • Springfield, NJ
National Provider Identifier
1447694864
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA11633600 Issued in NJ
Practice address
211 Mountain Ave Ste 300
Springfield, NJ 07081-2221
Phone
(973) 467-0005
Fax
(973) 912-8989
NPI assigned
Apr 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2020-00962 NC
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 25MA11633600 NJ Primary

Addresses

Primary practice location

211 Mountain Ave Ste 300
Springfield, NJ 07081-2221

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

140 Central Ave
Clark, NJ 07066-1121
Phone (973) 467-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, NJ3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20201023000392 NC Practitioner - Cardiovascular Disease (Cardiology) 7214230804 Reassigns benefits to 2 organizations
I20210909002974 SC Practitioner - Cardiovascular Disease (Cardiology) 7214230804 Reassigns benefits to 1 organization
I20230522002320 NJ Practitioner - Cardiovascular Disease (Cardiology) 7214230804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical University of South Carolina College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Health Consultants, P.a.Group PAC ID 8325934706, 118 clinicians
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5915

211 Mountain Ave
Springfield, NJ 07081-2221
Phone (973) 467-0005

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Robert Wood Johnson University Hospital at Rahway Hospital, Rahway, NJ, CCN 310024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-00962NCMDCardiovascular Disease Physician
25MA11633600NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 12, 2021 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Current Accepting new patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Oct 1, 2020 Accepting new patients
University Medical Associates of the Medical University of South Carol Cardiovascular Disease Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Oct 1, 2020 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Practice Associates Medical Group CurrentSince Jun 1, 2023 Accepting new patients
University Medical Associates CurrentSince Aug 12, 2021 Accepting new patients
Cardiovascular Health Consultants, P.a. CurrentSince Jun 1, 2023 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

140 Central Ave
Clark, NJ 07066
Phone (732) 499-0606

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

1400 Woodland Ave
Plainfield, NJ 07060
Phone (908) 753-1113

211 Mountain Ave
Springfield, NJ 07081
Phone (973) 467-0005

211 Mountain Ave
Ste 300
Springfield, NJ 07081
Phone (973) 467-0005

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697846400000",
    "number": "1447694864",
    "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": "211 MOUNTAIN AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070812221",
            "telephone_number": "973-467-0005",
            "fax_number": "973-912-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Clark",
            "state": "NJ",
            "postal_code": "070661121",
            "country_code": "US",
            "telephone_number": "973-467-0005",
            "fax_number": "973-912-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCELLIGOTT",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2020-00962",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA11633600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.