Active NPI
Lauren Rose Kelly, PA-C
- Physician Assistant
- Bronx, NY
National Provider Identifier
1871222836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 029036
- Practice address
- 234 E 149TH St
Bronx, NY 10451-5504 - Phone
- (718) 579-5000
- NPI assigned
- Jun 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 029036 | NY | Primary |
Addresses
Primary practice location
234 E 149TH St
Bronx, NY 10451-5504
Mailing address
1 Pace PLZ
New York, NY 10038-1598
Other practice location 1
1 Pace Plz
New York, NY 10038-1598
Phone (866) 722-3338
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- lauren.kelly.p28@direct.medcor.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665273600000",
"number": "1871222836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PACE PLZ",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100381598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 E 149TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104515504",
"telephone_number": "718-579-5000"
}
],
"practiceLocations": [
{
"address_1": "1 Pace Plz",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100381598",
"country_code": "US",
"telephone_number": "866-722-3338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "LAUREN",
"middle_name": "ROSE",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-06",
"last_updated": "2022-10-09",
"certification_date": "2022-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "029036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.