Carissa M Kelly, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F311018-01 Issued in NY

Practice address

45 Dan Rd
Canton, MA 02021-2852

Phone

(914) 525-8692

Fax

(630) 376-7615

NPI assigned

Sep 28, 2010

Last updated

Jun 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, RI, NH, OR, ME, NY, PA, CT, IN, FL, OH, MD, VA, WV, DE, MO, VT, TN, NM, KY, WA, NV, AZ, ID, SC, MN, IL, CA, WI29 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 29

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ibis Health Services- Massachusetts LLCGroup PAC ID 4486998994, 9 clinicians

Post Acute Telehealth PCGroup PAC ID 9638585391, 63 clinicians

First Person Care ClinicGroup PAC ID 2961649207, 10 clinicians

Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians

Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians

Ibis Health Services-New Hampshire PLLCGroup PAC ID 4486904422, 4 clinicians

Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Telemedicine Group PCGroup PAC ID 9830351824, 94 clinicians

Ibis Health Services-Maine LLCGroup PAC ID 5698019131, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles (60 of 99)

Locations (25 of 178)

Interoperability endpoints

• Direct secure messaging: carissa.kelly.1@24694.direct.athenahealth.com
• Direct secure messaging: carissa.kelly.1@30919.direct.athenahealth.com
• Direct secure messaging: carissa.kelly.1@5296.direct.athenahealth.com
• Direct secure messaging: carissa.kelly@778128272654340.direct.elationemr.com
• Direct secure messaging: carissa.kelly@979703123607556.direct.elationemr.com
• FHIR API: https://app.meldrx.com/api/fhir/caredimensions
• FHIR API: https://fhir4.healow.com/fhir/r4/HCGDDD
• Direct secure messaging: romtechnologiesinc.carissakelly@156161.advancedmd-direct.com
• Direct secure messaging: telemed2u.carissakelly@160918.advancedmd-direct.com

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.

• Daniel Funsch Jr, M.D., P.C.

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1316784580

  FL

  Medicare reassignment Care Compare group NPD
• First Person Care Clinic

  dba First Person Complete Care

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1659612547
  Medicare reassignment Care Compare group NPD
• Ibis Health Services-Maine LLC

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1942798707
  Medicare reassignment Care Compare group NPD
• Ibis Health Services-New Hampshire PLLC

  • Family Medicine Physician
  • Nashua, NH
  • NPI 1871087619
  Medicare reassignment Care Compare group NPD
• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798

  NH, WV

  Medicare reassignment Care Compare group NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  FL, IL, IN, MN, PA, TN, WA, WI

  Medicare reassignment Care Compare group NPD
• Telehealth Specialty Medical Group

  dba TeleMed2U

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment Care Compare group NPD
• Ibis Health Services- Massachusetts, LLC

  • Internal Medicine Physician
  • Harvard, MA
  • NPI 1790273563

  CT, PA, RI

  Medicare reassignment Care Compare group
• Post Acute Telehealth PC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1164011185

  IN, MA

  Medicare reassignment Care Compare group
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914

  Nurse Practitioner

  Medicare reassignment NPD
• Bay Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Randolph, MA
  • NPI 1659097483
  Medicare reassignment NPD
• Bond Medical Consultants, PC

  • Family Medicine Physician
  • Westwood, MA
  • NPI 1629479472
  Medicare reassignment NPD

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1821307646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FALES RD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671086",
            "telephone_number": "914-525-8692",
            "fax_number": "630-376-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DAN RD",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212852",
            "telephone_number": "914-525-8692",
            "fax_number": "630-376-7615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Chestnut St Ste 303A2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191063024",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 Main St Ste 206A",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976016007",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1980 E 116th St Ste 315",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460323517",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "122 Delaware Street SteF-5",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "DE",
            "postal_code": "197204814",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Green Valley Pkwy Ste 213",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890746177",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1094 Killingly Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Dayville",
            "state": "CT",
            "postal_code": "062412187",
            "country_code": "US",
            "telephone_number": "727-601-4513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CARISSA",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP211393",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN276785",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN02561",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "084141-23",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704397659",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11021654",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "7947",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311018-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Keddy, LICSW
• Roxanne Kelber, LICSW
• Kerri A Keleher, RDH
• Jack Keller, PMHNP-BC
• Maureen Patricia Kelly-Chamoun, MA CCC-SLP
• Charlene Ann Kelly, LMHC
• Meg D Kennedy, L.M.H.C.
• Gina Khalid
• Kevin Kim, D.M.D., PH.D.
• Kindness Dental Care

• Adult Health Nurse Practitioner in Canton, MA
• Providers in Canton, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.

Verify at the official NPI Registry.