Individual provider Active NPI

Brian Joseph Kelly, D.O

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1679839831
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34012659 Issued in OH
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5500
NPI assigned
Apr 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 265830 MA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 34012659 OH Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

7109 Ravens Run
Cincinnati, OH 45244-3594
Phone (513) 384-4235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20170630002108 OH Practitioner - Anesthesiology 6406147255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Cincinnati, IncGroup PAC ID 4789598509, 126 clinicians

Practice addresses (Care Compare)

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34012659OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Cincinnati, Inc Anesthesiology CurrentSince Jul 10, 2017 Accepting new patients

Locations

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

Organizations & group practices 1

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 1

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1679839831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 RAVENS RUN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452443594",
            "telephone_number": "513-384-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "265830",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34012659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.