NPIMap

Individual provider Active NPI

John P Kelly, D.O.

  • Anesthesiology Physician
  • Roslyn, NY
National Provider Identifier
1902819386
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
228102 Issued in NY
Practice address
100 Port Washington Blvd
Roslyn, NY 11576-1353
Phone
(516) 627-6624
Fax
(516) 627-3804
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 228102 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Roslyn, NY 11576-1353

Mailing address

100 Port Washington Blvd
Roslyn, NY 11576-1353
Phone (516) 627-6624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050711000831 NY Practitioner - Anesthesiology 7517993587 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 627-6624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.24 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228102NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince Mar 1, 2020 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. Anesthesiology CurrentSince Jul 1, 2005 Accepting new patients
Gastrointestinal Care of Long Island PLLC CurrentSince Oct 1, 2024 Accepting new patients
Digestive Healthcare Associates, P.C. CurrentSince Nov 1, 2023 Accepting new patients
St. Francis Hospital Current Accepting new patients
Meadowbrook Medical Associates Anesthesiology CurrentSince Sep 8, 2014 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Mar 1, 2020 Accepting new patients

Locations

310 E Shore Rd
Ste 206
Great Neck, NY 11023
Phone (516) 487-7677

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

865 Merrick Ave
Ste 150N
Westbury, NY 11590
Phone (516) 542-3636

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902819386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-627-6624",
            "fax_number": "516-627-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-627-6624",
            "fax_number": "516-627-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "228102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.