Dana Alexandra Kelly, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11554 Issued in MA

Practice address

1 Bowdoin St
Boston, MA 02114-4201

Phone

(810) 923-5702

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

Yes

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 MA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

R Franklin University of Med & Sci/Chicago Medical School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kandm Neuropsychology, a Psychology CorporationGroup PAC ID 8921373184, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• K&M Neuropsychology, a Psychology Corporation

  • Clinic/Center
  • Mill Valley, CA
  • NPI 1760900831
  Medicare reassignment Care Compare group NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1548843600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOWDOIN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOWDOIN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144201",
            "telephone_number": "810-923-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DANA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-09-21",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciaran P Kelly, M.D.
• Claire Kelly, PA-C
• Clare Kelly
• Colleen Kelly, MD
• Colleen Anne Kelly, MD
• Daniel Patrick Kelly, M.D.
• Deana Ashley Kelly, NP
• Dearbhla Marie Kelly, MBBCHBAO MSC DPHIL
• Elizabeth Lee Kelly, FNP
• Emer M Kelly, MB.BCH

• Clinical Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.