Individual provider Active NPI

John Daniel Kelly, M.D.

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1730324740
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N7442 Issued in TX
Practice address
2002 Holcombe Blvd
Houston, TX 77030-4211
Phone
(713) 791-1414
NPI assigned
Dec 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A123809 CA
Internal Medicine Physician 207R00000X N7442 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2002 Holcombe Blvd
Houston, TX 77030-4211

Mailing address

1 Hermann Museum Circle Dr
Apt 2114
Houston, TX 77004-7174

Other practice location 1

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 547-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160725000495 CA Practitioner - Infectious DiseasePractitioner - Hospitalist 8022286566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N7442TXMDInternal Medicine Physician
A123809CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Jul 5, 2022 Accepting new patients
City and County of San Francisco CurrentSince Jul 5, 2022 Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

Interoperability endpoints

  • Direct secure messaging: jkelly@yourcarecommunity.org

Organizations & group practices 3

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1730324740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HERMANN MUSEUM CIRCLE DR",
            "address_2": "APT 2114",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-791-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 Montgomery Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954054801",
            "country_code": "US",
            "telephone_number": "707-547-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A123809",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7442",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.