Individual provider Active NPI

John D Kelly IV, MD

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1538158472
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD034751E Issued in PA
Practice address
3400 Spruce St
2 Silverstein Building
Philadelphia, PA 19104-4206
Phone
(215) 662-3340
Fax
(215) 349-5928
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD034751E PA Primary

Addresses

Primary practice location

3400 Spruce St
2 Silverstein Building
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
2 Silverstein Building
Philadelphia, PA 19104-4206
Phone (215) 662-3340

Other identifiers 1

IdentifierTypeStateIssuer
0012052630001MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031114000076 PA Practitioner - Orthopedic Surgery 8628982626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Cincinnati College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

145 King of Prussia Rd
Radnor, PA 19087-4557

145 King of Prussia Rd 201
Radnor, PA 19087-4557

145 King of Prussia Rd 203
Radnor, PA 19087-4557

145 King of Prussia Rd 302
GYN/Onc Radnor
Radnor, PA 19087-4557
Phone (610) 902-2500

145 King of Prussia Rd N
G102 Oto Surgery Radnor
Philadelphia, PA 19087-4557
Phone (610) 902-5500

145 King of Prussia Rd N G
1 Rad Onc Rdanor
Radnor, PA 19087-4557
Phone (610) 902-4580

145 King of Prussia Road G-103
Oral/Maxillo Surg Radnor
Radnor, PA 19087-4557
Phone (610) 902-2100

235 S 33Rd St
Philadelphia, PA 19104-6322
Phone (215) 662-3340

321 N Furnace St
Birdsboro, PA 19508-2057
Phone (610) 582-2250

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

51 N 39TH St
Philadelphia, PA 19104-2640

51 N 39TH Street
Gi Surgery PPMC
Philadelphia, PA 19104-2640
Phone (215) 662-9198

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)53
Upper limb (arm) arthroscopy (minimally invasive joint repair)33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD034751EPAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients

Locations

1001 Chesterbrook Blvd
Fl 3
Berwyn, PA 19312
Phone (610) 576-7500

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

3737 Market St
Fl 7
Philadelphia, PA 19104

235 S 33rd St
Philadelphia, PA 19104
Phone (215) 615-4400

3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333

301 S 8th St
Ste 2C
Philadelphia, PA 19106
Phone (215) 829-5022

145 King of Prussia Rd
Ste 305
Radnor, PA 19087
Phone (610) 902-5700

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

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.

Hospital & facility affiliations 6

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1538158472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 SILVERSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3340",
            "fax_number": "215-349-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 SILVERSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3340",
            "fax_number": "215-349-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD034751E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012052630001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.