Jeremy Maclaren Kelly, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024880-01 Issued in NY

Practice address

179 Sullys TRL Ste 200
Pittsford, NY 14534-4500

Phone

(585) 276-6900

Fax

(585) 273-1066

NPI assigned

May 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkelly183284@direct.urmc.rochester.edu

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.

• University of Rochester Department of Psychiatry Clinical Group

  • Psychiatry Physician
  • Rochester, NY
  • NPI 1326088808
  Medicare reassignment NPD
• Harry M. Barsuk, LMHC, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Geneseo, NY
  • NPI 1043981731
  NPD
• Meridian Psychology Practice, PLLC

  • Clinical Psychologist
  • Geneseo, NY
  • NPI 1043921984
  NPD
• University of Rochester

  dba Strong Memorial Hospital MD Group

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD (past)

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1548825078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD BOX PSYCH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 SULLYS TRL STE 200",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344500",
            "telephone_number": "585-276-6900",
            "fax_number": "585-273-1066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 South St",
            "address_purpose": "LOCATION",
            "city": "Geneseo",
            "state": "NY",
            "postal_code": "144541310",
            "country_code": "US",
            "telephone_number": "585-770-7190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JEREMY",
        "middle_name": "MACLAREN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "24880",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024880-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelly183284@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelly183284@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsay Kaplan, CCC-SLP
• Kathryn Lechner, Nurse Practitioner in Psychiatry, PLLC
• Olivia Keefer
• Jacquelyn Keicher, RDN
• Virginia Kelley, F.N.P
• Katylin Kelly, MA, CCC-SLP
• Aimee Kelsey, LPN
• Valerie Kenyon
• Howard Kessler, D.O.
• James David Kestenbaum, PH.D.

• Clinical Psychologist in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.