Individual provider Active NPI

John J Kelemen III, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Hilton Head Island, SC
National Provider Identifier
1871554212
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
01075452A Issued in IN
Practice address
25 Hospital Center Blvd Ste 306
Hilton Head Island, SC 29926-2739
Phone
(843) 689-8224
Fax
(843) 689-8360
NPI assigned
Mar 28, 2006
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 04-31210 KS
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 34064 WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01075452A IN Primary

Addresses

Primary practice location

25 Hospital Center Blvd Ste 306
Hilton Head Island, SC 29926-2739

Mailing address

PO Box 21964
Belfast, ME 04915-4116
Phone (708) 342-6900

Other identifiers 4

IdentifierTypeStateIssuer
000001006309OtherINANTHEM PROVIDER NUMBER
201291370MedicaidIN
200326510AMedicaidKS
200326510DMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190418001677 SC Practitioner - Thoracic Surgery 9234179201 Reassigns benefits to 1 organization
I20221122001971 TX Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 9234179201 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-31210KSMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
34064WIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 19, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 19, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Nov 13, 2025 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Nov 13, 2025 Accepting new patients
Cedar Surgical LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Mar 15, 2007 Accepting new patients
Mid America Surgical Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3341 Unicorn Lake Blvd
Denton, TX 76210
Phone (469) 814-4475

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/gemms-ced01
  • Direct secure messaging: jkelemen1125680@direct.sw.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Jan 3, 2024
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Jan 3, 2024
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1871554212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21964",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154116",
            "telephone_number": "708-342-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD STE 306",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262739",
            "telephone_number": "843-689-8224",
            "fax_number": "843-689-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELEMEN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KS",
            "license": "04-31210",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "34064",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01075452A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000001006309",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201291370",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200326510A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200326510D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.