Individual provider Active NPI

Marien Rodriguez Kelly, DPM

  • Podiatrist
  • Coral Gables, FL
National Provider Identifier
1740547520
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3679 Issued in FL
Practice address
3146 Coral Way
Coral Gables, FL 33145-3210
Phone
(786) 536-9656
NPI assigned
Apr 18, 2012
Last updated
Jan 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO3679 FL Primary

Addresses

Primary practice location

3146 Coral Way
Coral Gables, FL 33145-3210

Mailing address

15720 Bull Run Rd Apt 380H
Miami Lakes, FL 33014-2191
Phone (786) 368-6815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150213000569 FL Practitioner - Podiatry 5799000725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

518 Payne Dr
Miami Springs, FL 33166-4946
Phone (786) 368-6815

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue77
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3679FLMDPodiatrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1740547520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 BULL RUN RD APT 380H",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142191",
            "telephone_number": "786-368-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 CORAL WAY",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453210",
            "telephone_number": "786-536-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARIEN",
        "middle_name": "RODRIGUEZ",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.