Susan C Kelly, D.O.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

DO00604 Issued in RI

Practice address

7 Weaver Rd
North Kingstown, RI 02852-7135

Phone

(401) 667-0905

Fax

(401) 667-0590

NPI assigned

Jun 6, 2006

Sex

Female

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

Enrolled in RI

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

Specialty

DermatologyAlso: Pathology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Sue Kelly Dermatology, LLC

  • Dermatopathology Physician
  • North Kingstown, RI
  • NPI 1851573760
  Medicare reassignment NPD Authorized official
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1548200074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WEAVER RD",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028527135",
            "telephone_number": "401-667-0905",
            "fax_number": "401-667-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WEAVER RD",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028527135",
            "telephone_number": "401-667-0905",
            "fax_number": "401-667-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SUSAN",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "RI",
            "license": "DO00604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Treloar Licsw LLC
• Kelley Gemma, LLC
• Kelley Gemma, LLC Dba Ocean State Psychotherapy, Inc.
• Mark Damien Kelley, MD
• Karlene A Kelly, SLP
• Prachi Kene, PHD, ABPP
• George Anthony Kenna, PHD, RPH
• Linda Kenyon
• Karen E Kershaw, LMFT
• Kayla E Kiers, RN

• Dermatopathology Physician in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Dermatopathology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.
• 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.