Michael B Kelleher, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

196028 Issued in NY

Practice address

4939 Brittonfield Pkwy
209
East Syracuse, NY 13057-9208

Phone

(315) 218-0085

Fax

(315) 218-0087

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jamaica Hospital

  dba Jamaica Hospital Emergency Department - Radiology

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1851475800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 209",
            "address_2": "EAST SYRACUSE",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-218-0085",
            "fax_number": "315-218-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "address_2": "209",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-218-0085",
            "fax_number": "315-218-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "196028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda B Kaufman, PT
• Forde Kay
• Sue Ann Kayne, PT
• Megan Keating, PT
• Kristin M. Keim, MSTSHH
• Lynn Doris Kells, CCC-SLP
• Kelly Obrien Licensed Clinical Social Worker
• Lauren Kennedy, MS, CAS
• Melinda Kernan
• Christine Khanzadian

• Anatomic Pathology & Clinical Pathology Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.