Individual provider Active NPI

Kelly E Kraines, PA

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1457827115
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7879 Issued in MA
Practice address
450 Brookline Ave
Boston, MA 02215-5450
Phone
(617) 632-3800
Fax
(617) 632-1930
NPI assigned
Oct 22, 2018
Last updated
Apr 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7879 MA Primary
Physician Assistant 363A00000X 10002607A IN
Medical Physician Assistant 363AM0700X MA061775 PA

Addresses

Primary practice location

450 Brookline Ave
Boston, MA 02215-5450

Mailing address

450 Brookline Ave
Boston, MA 02215-5450
Phone (617) 632-3800

Other practice location 1

514 W 2nd St
Bloomington, IN 47403-2316
Phone (812) 676-4444

Other names 1

  • Kelly E Helvenston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20210428003138 MA Practitioner - Physician Assistant 6901140391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA7879MAMDPhysician Assistant
MA061775PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. Current Accepting new patients
University of Penn-Medical Group CurrentSince Sep 21, 2020 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Apr 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 21, 2020 Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

145 King of Prussia Rd
Ste 200
Radnor, PA 19087
Phone (610) 902-4580

Interoperability endpoints

  • Direct secure messaging: kraines.kelly.dfci@direct.partners.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1457827115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-3800",
            "fax_number": "617-632-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-3800",
            "fax_number": "617-632-1930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032316",
            "country_code": "US",
            "telephone_number": "812-676-4444",
            "fax_number": "812-676-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAINES",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7879",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002607A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "HELVENSTON",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.