NPIMap

Individual provider Active NPI

Kelly Leddy Guiliano, PA-C

  • Surgical Physician Assistant
  • Brick, NJ
National Provider Identifier
1548756182
Registry record updated Jul 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00480700 Issued in NJ
Practice address
457 Jack Martin Blvd
Brick, NJ 08724-7776
Phone
(732) 840-7500
Fax
(732) 840-2088
NPI assigned
Jul 6, 2018
Last updated
Jul 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00480700 NJ
Surgical Physician Assistant 363AS0400X 25MP00480700 NJ Primary

Addresses

Primary practice location

457 Jack Martin Blvd
Brick, NJ 08724-7776

Mailing address

457 Jack Martin Blvd
Brick, NJ 08724-7776
Phone (732) 840-7500

Other names 1

  • Kelly Lynn Leddy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003001033 NJ Practitioner - Physician Assistant 1951653922 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

226 Route 37 W
Toms River, NJ 08755-8047
Phone (732) 240-6060

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00480700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC CurrentSince Apr 1, 2021 Accepting new patients
Professional Orthopaedic Assoc PA CurrentSince Aug 5, 2019 Accepting new patients
Orthonj LLC CurrentSince Apr 1, 2021 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Dec 10, 2018 Accepting new patients

Locations

457 Jack Martin Blvd
Brick, NJ 08724
Phone (732) 840-7500

765 Lacey Rd
Forked River, NJ 08731
Phone (732) 840-7500

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

999 Route 73 N
Ste 401
Marlton, NJ 08053
Phone (609) 617-3546

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

776 Shrewsbury Ave
Ste 102
Tinton Falls, NJ 07724
Phone (732) 590-4949

776 Shrewsbury Ave
Ste 105
Tinton Falls, NJ 07724
Phone (732) 530-4949

776 Shrewsbury Ave
Ste 201
Tinton Falls, NJ 07724
Phone (732) 530-4949

1430 Hooper Ave
Ste 101
Toms River, NJ 08753

Interoperability endpoints

  • Direct secure messaging: kleddy425251@direct.ahsys.org

Organizations & group practices 5

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 5

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753574400000",
    "number": "1548756182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247776",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247776",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILIANO",
        "first_name": "KELLY",
        "middle_name": "LEDDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2025-07-27",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00480700",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00480700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LEDDY",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.