Kellie Anne Antonellos, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ14963800 Issued in NJ

Practice address

1 Washington Blvd
Robbinsville, NJ 08691-3162

Phone

(609) 448-4353

NPI assigned

Nov 29, 2023

Last updated

Nov 29, 2023By the provider in NPPES

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 NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinical Health Care Associates of New Jersey, P.C.

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1447260435
  Medicare reassignment Care Compare group NPD

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

• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  dba Penn Medicine Princeton Medical Center

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1629844766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON BLVD",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086913162",
            "telephone_number": "609-448-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON BLVD",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086913162",
            "telephone_number": "609-448-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLOS",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14963800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allies, Inc.
• Allies, Inc.
• Allies, Inc.
• Maqsood Amjad, M.D.
• Tammy Anderson, DVM
• Arc Mercer, Inc
• Arc Mercer, Inc
• Arc Mercer, Inc
• Arc Mercer, Inc
• Arc Mercer, Inc

• Nurse Practitioner in Robbinsville, NJ
• Providers in Robbinsville, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.