John J Kelly, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS005933L Issued in PA

Practice address

5501 Old York Rd
Philadelphia, PA 19141

Phone

(215) 456-6679

Fax

(215) 456-8502

NPI assigned

Mar 17, 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 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.kelly@direct.einstein.edu

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.

• Einstein Practice Plan Inc

  dba Einstein Psychiatry Assoc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment NPD
• Fornance Physician Services, Inc

  dba Family OB/GYN Center

  • Obstetrics & Gynecology Physician
  • Norristown, PA
  • NPI 1053363523
  Medicare reassignment NPD
• Einstein Practice Plan Inc

  dba Tabor Emergency Physicians

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1457304198
  NPD
• Fornance Physician Services

  dba Einstein Physician Montgomery-Observation Suite

  • Emergency Medical Services (Emergency Medicine) Physician
  • East Norriton, PA
  • NPI 1316596737
  NPD
• Fornance Physician Services, Inc.

  • Neurological Surgery Physician
  • Plymouth Meeting, PA
  • NPI 1699459388
  NPD

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1467421644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13918",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19101",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-456-6679",
            "fax_number": "215-456-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS005933L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001134134",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Kelly, MSPT
• Jessica Kelly, MD
• Jillian Alexandria Kelly, CRNP
• Joanne Kelly
• John D Kelly IV, MD
• John James Kelly
• Julia Kelly, MD
• Kacey Kelly
• Katherine Louisa Kelly, CRNP
• Kiva Darlene Kelly

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.