Michael Kelly

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00331600 Issued in NJ

Practice address

573 Amboy Ave
Woodbridge, NJ 07095-3049

Phone

(908) 282-3737

NPI assigned

Oct 19, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Health & Fitness Professionals LLC

  • Sports Physical Therapist
  • Scotch Plains, NJ
  • NPI 1447628581
  NPD

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

{
    "created_epoch": "1729296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1497576722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S DOUGHTY AVE APT 203",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 AMBOY AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070953049",
            "telephone_number": "908-282-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-19",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00331600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashmi Kamath Talpady, LAC
• Jennifer Elena Kantor, DMD
• Russell Scott Kateman, OD
• Kavita Bupathi MD LLC
• Cheri M Keim, OTR/L
• Bilgin Kerisli, DC
• Kidney Life, LLC
• Heather Nicole Kish, OTR/L
• Kishore N. Ramchandani M.D.
• Janet M Kline, LCSW

• Physical Therapy Assistant in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.