John Peter Kelly, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

014000 Issued in NY

Practice address

21 Dorothy LN
Kings Park, NY 11754-2932

Phone

(631) 265-3168

NPI assigned

Oct 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC

  • Physical Therapist
  • Holbrook, NY
  • NPI 1326355132
  Medicare reassignment

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1497055008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DOROTHY LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DOROTHY LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542932",
            "telephone_number": "631-265-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie J. Kamen
• Eileen Kane-Gemmell, RD
• Melanie Karuschkat, M.S.P.T.
• June Keegan, L.M.T.
• Katherine Elizabeth Keller
• Shannon Kelly
• Mary T Kenavan
• Heather F Kennedy
• Rachael Kern
• KFP Corp

• Occupational Therapist in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.