Kelley Elizabeth Driscoll, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

345118 Issued in NY

Practice address

3559 E South St
Long Beach, CA 90805-4519

Phone

(562) 354-4410

Fax

(888) 972-1912

NPI assigned

Dec 16, 2019

Sex

Female

Sole proprietor

No

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

Enrolled in NY, CA, MD, DC4 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 4

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ophelia Medical Group FL, P.a.

  • Addiction Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1588244750

  DC, MD, NY

  Medicare reassignment Care Compare group NPD
• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782
  Medicare reassignment NPD
• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment
• Orange County Urgent Care #3, Inc.

  dba MedPost - Lakewood

  • Urgent Care Clinic/Center
  • Long Beach, CA
  • NPI 1619445111
  NPD (past)

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1881232387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052031",
            "telephone_number": "442-347-7418",
            "fax_number": "888-972-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3559 E SOUTH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054519",
            "telephone_number": "562-354-4410",
            "fax_number": "888-972-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 Cornelia St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129012332",
            "country_code": "US",
            "telephone_number": "518-563-2404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "KELLEY",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Dressner, M.D.
• Zakiyyah Tunane Drew
• Harry Dreyfuss
• Rosilene Driggs
• Emily Jane Drinkwine, EDS, PPS, NCSP
• Lena Cara Driscoll, RN
• Tenzin Thupten Drongar
• Drop-in Partnership
• DRS. Emily & Dustin Dodds, a Professional Dental Corporation (Dodds Dental)
• Jayden Drummer

• Family Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.