Active NPI
John Michael Kelley, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Utica, NY
National Provider Identifier
1750338745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 190295-1
- Practice address
- 2211 Genesee St
Utica, NY 13501-5930 - Phone
- (315) 733-7798
- Fax
- (315) 733-7893
- NPI assigned
- May 27, 2006
- Last updated
- Apr 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 190295-1 | NY | Primary |
Addresses
Primary practice location
2211 Genesee St
Utica, NY 13501-5930
Mailing address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-4770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01489990 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Surgery
- Education
- University of Vermont College of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Atwell Rd
Cooperstown, NY 13326-1394
178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456
Hospital & facility affiliations
- HCR / HCR Home Care Chha (Oneonta)
- Bassett Healthcare
- Aurelia Osborn Fox Memorial Hospital
- Little Falls Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.62 of 100
- Quality
- 77.97
- Promoting interoperability
- 98
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 25 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190295-1 | NY | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Toby a Taylor | Past | Accepting new patients | |
| Frederic S Joyce MD PC | Past | Accepting new patients | |
| Mohawk Valley Surgery Group | Past | Accepting new patients | |
| Mary Imogene Bassett Hospital | Past | Accepting new patients |
Locations
178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456
1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480
Interoperability endpoints
- jkelley5856@bassett.direct-ci.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Bassett Medical Center
- Multi-Specialty Clinic/Center
- Cooperstown, NY
- NPI 1083664221
-
dba Bassett Healthcare
- Rural Acute Care Hospital
- Cooperstown, NY
- NPI 1780600577
-
- Specialist
- Utica, NY
- NPI 1578654828
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oneonta, NY
- NPI 1578529954
-
- Critical Access Hospital
- Little Falls, NY
- NPI 1558321919
-
dba Bassett Healthcare
- Rural Acute Care Hospital
- Cooperstown, NY
- NPI 1780600577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1750338745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261301",
"telephone_number": "607-547-4770",
"fax_number": "607-547-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 GENESEE ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135015930",
"telephone_number": "315-733-7798",
"fax_number": "315-733-7893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NY",
"license": "190295-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01489990",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.