Individual provider Active NPI

Kelly Pajela, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Peabody, MA
National Provider Identifier
1811214471
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
244907 Issued in MA
Practice address
4 Centennial Dr
Suite 204
Peabody, MA 01960-7935
Phone
(978) 977-0351
Fax
(978) 977-0562
NPI assigned
Apr 22, 2010
Last updated
Nov 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 244907 MA Primary

Addresses

Primary practice location

4 Centennial Dr
Suite 204
Peabody, MA 01960-7935

Mailing address

4 Centennial Drive
Suite 204
Peabody, MA 01960-9993
Phone (978) 977-0351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101019000705 MA Practitioner - Physical Medicine and Rehabilitation 5890988166 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244907MAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Sep 20, 2010 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

4 Centennial Dr
Ste 204
Peabody, MA 01960
Phone (978) 977-0351

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": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1811214471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CENTENNIAL DRIVE",
            "address_2": "SUITE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019609993",
            "telephone_number": "978-977-0351",
            "fax_number": "978-977-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CENTENNIAL DR",
            "address_2": "SUITE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607935",
            "telephone_number": "978-977-0351",
            "fax_number": "978-977-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJELA",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-22",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "244907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.