Individual provider Active NPI

Kelli Laura Nayak, M.D.

  • Pediatric Sports Medicine Physician
  • Allentown, PA
National Provider Identifier
1699755488
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
MD458087 Issued in PA
Practice address
1621 N Cedar Crest Blvd Ste 102
Allentown, PA 18104-2304
Phone
(610) 402-8900
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD458087 PA
Pediatrics Physician 208000000X ME106614 FL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD458087 PA
Pediatric Sports Medicine Physician 2080S0010X MD458087 PA Primary
Pediatrics Physician 208000000X 219067 MA

Addresses

Primary practice location

1621 N Cedar Crest Blvd Ste 102
Allentown, PA 18104-2304

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20161005000773 PA Practitioner - Pediatric MedicinePractitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4082809777 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME106614FLMDPediatrics Physician
219067MAMDPediatrics Physician
MD458087PAMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Sep 12, 2016 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 12, 2016 Accepting new patients
Valley Health Partners Community Health Center Current Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Physician Group Past Accepting new patients

Locations

1627 Chew St
Allentown, PA 18102
Phone (610) 969-2388

1621 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 402-3300

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1621 N Cedar Crest Blvd
Ste 102
Allentown, PA 18104

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

3371 Route 100
Ste 205
Macungie, PA 18062

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1699755488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 N CEDAR CREST BLVD STE 102",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042304",
            "telephone_number": "610-402-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYAK",
        "first_name": "KELLI",
        "middle_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD458087",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME106614",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "MD458087",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "PA",
            "license": "MD458087",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "219067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.