Active NPI
Kelly Elizabeth Dewey, M.D.
- Pediatrics Physician
- Cooperstown, NY
National Provider Identifier
1881058055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 312335
- Practice address
- 1 Atwell Rd
Cooperstown, NY 13326-1301 - Phone
- (607) 547-3456
- NPI assigned
- Apr 13, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD467541 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 827893095 | NY | |
| Pediatrics Physician | 208000000X | 312335 | NY | Primary |
Addresses
Primary practice location
1 Atwell Rd
Cooperstown, NY 13326-1301
Mailing address
1 Atwell Rd
Cooperstown, NY 13326-1394
Phone (607) 547-3456
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 827893095 | NY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Past | Accepting new patients |
Locations
178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456
1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480
Organizations & group practices 3
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.
-
dba Bassett Medical Center
- Multi-Specialty Clinic/Center
- Cooperstown, NY
- NPI 1083664221
-
dba Bassett Healthcare
- Rural Acute Care Hospital
- Cooperstown, NY
- NPI 1780600577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1881058055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261394",
"telephone_number": "607-547-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261301",
"telephone_number": "607-547-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWEY",
"first_name": "KELLY",
"middle_name": "ELIZABETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD467541",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "827893095",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "312335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cooperstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.