Dylan Kelleher, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1018851 Issued in MA

Practice address

800 Washington St
Boston, MA 02111-1552

Phone

(617) 636-5000

NPI assigned

Jun 9, 2020

Last updated

Jun 5, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Emergency Medicine

Education

Marian University College of Osteopathic Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lawrence General HospitalGroup PAC ID 5092725200, 124 clinicians

Community Medical Associates, Inc.Group PAC ID 6002946928, 155 clinicians

Tufts Medical Center Ep LLCGroup PAC ID 0446306716, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tufts Medical Center Hospital, Boston, MA, CCN 220116
• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkelleher112180@tuftsmedicine.direct-ci.com

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.

• Community Medical Associates, Inc.

  • Family Medicine Physician
  • Lawrence, MA
  • NPI 1144544040
  Medicare reassignment Care Compare group NPD
• Tufts Medical Center Ep LLC

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1609015262
  Medicare reassignment Care Compare group NPD
• Lawrence General Hospital

  dba Merrimack Health Lawrence Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Medicare reassignment Care Compare group
• General Primary Care of Lawrence

  • Hospitalist Physician
  • Lawrence, MA
  • NPI 1801023189
  NPD
• Lawrence General Hospital

  dba LGH Vaccination Clinic

  • Allergy & Immunology Physician
  • Lawrence, MA
  • NPI 1881272102
  NPD

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

• Lawrence General Hospital

  dba Merrimack Health Lawrence Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation
• Tufts Medical Center, Inc.

  dba Tufts Medical Center

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1659996270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT020176",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1018851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna B. Kelleher-Yassen, CCRN, FNP-C
• Ali Kelleher, MS BCBA LABA
• Alyson Joy Kelleher, OD
• Cassandra Michelle Kelleher, MD
• Daniel Kelleher, DPT
• Eoin Maurice Kelleher, MB BCH
• Kerriann Kelleher, LICSW
• Raymond J Kelleher III, MD PHD
• Shannon Kelleher
• Stephen Kelleher, M.D.

• Emergency Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.