NPIMap

Individual provider Active NPI

James David Kelleher Jr., M.D.

  • Anesthesiology Physician
  • Roslyn, NY
National Provider Identifier
1669738571
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
282852-1 Issued in NY
Practice address
100 Port Washington Blvd
New York Cardiovascular Anesthesiologists, P.C.
Roslyn, NY 11576-1347
Phone
(609) 313-2072
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 282852-1 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
New York Cardiovascular Anesthesiologists, P.C.
Roslyn, NY 11576-1347

Mailing address

100 Port Washington Blvd
New York Cardiovascular Anesthesiologists, P.C.
Roslyn, NY 11576-1347
Phone (609) 313-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613001186 NY Practitioner - Anesthesiology 8820388390 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rutgers School of Dental Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians
Digestive Healthcare Associates PCGroup PAC ID 4486546686, 16 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 627-6624

310 E Shore Rd
Suite 206
Great Neck, NY 11023-2432
Phone (516) 487-7677

Hospital & facility affiliations

  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Merit-based Incentive Payment System (MIPS)

Final score
94.24 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
282852NYMDLicensed Practical Nurse
282852-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Cardiovascular Anesthesiologists, P.C. Anesthesiology CurrentSince Jul 10, 2016 Accepting new patients
St. Francis Hospital Current Accepting new patients
St. Francis Hospital CurrentSince Mar 1, 2020 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Mar 1, 2020 Accepting new patients
Digestive Healthcare Associates, P.C. CurrentSince Mar 1, 2019 Accepting new patients
Gastrointestinal Care of Long Island PLLC PastSince Oct 1, 2024 Accepting new patients

Locations

310 E Shore Rd
Ste 206
Great Neck, NY 11023
Phone (516) 487-7677

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1669738571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C.",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "609-313-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C.",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "609-313-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "282852-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.