Brooke K Kelly, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

206222 Issued in NY

Practice address

207 Foote Ave
Jamestown, NY 14701-7077

Phone

(716) 664-7558

Fax

(716) 664-7559

NPI assigned

May 16, 2006

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

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physical Medicine and Rehabilitation

Education

New York College of Osteo Medicine of New York Institute of Technology, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239

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.

• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176
  Medicare reassignment Care Compare group NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1558313999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-664-7558",
            "fax_number": "716-664-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-664-7558",
            "fax_number": "716-664-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BROOKE",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "206222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01933522",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brooke.kelly@upmcdirect.com",
            "affiliation": "N",
            "address_1": "207 Foote Ave",
            "city": "Jamestown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147017077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adam Michael Karnes, PHARMD.
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• Akashdeep Kaur-Brar
• Daniel Allyn Keefe, R.N.
• Jessica Marie Keeler
• Derek Kennedy
• Amanda Rose Kent, PMHNP
• Peggy Sue Kestler, NP
• Tariq Mahmood Khan, M.D.
• Kiantone Independent Fire Department, Inc.

• Physical Medicine & Rehabilitation Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.