James Kelly, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003867 Issued in NY

Practice address

7035 113TH St
Forest Hills, NY 11375-4651

Phone

(718) 990-4648

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Boro Medical, P.C.

  • Surgical Physician Assistant
  • Bronx, NY
  • NPI 1528086584
  NPD (past)
• Boro Medical, P.C.

  • Podiatrist
  • Long Island City, NY
  • NPI 1588682454
  NPD (past)
• Lifeco Medical, P.C.

  • Emergency Medicine Physician
  • Forest Hills, NY
  • NPI 1922031905
  NPD (past)
• The Parkway Hospital

  • General Acute Care Hospital
  • Forest Hills, NY
  • NPI 1124060538
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1902840549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32635",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061502635",
            "telephone_number": "800-795-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 113TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754651",
            "telephone_number": "718-990-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "003867",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01638059",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Keil, LMSW
• Nicole Anne Keiley, DPM
• Raya Sophia Elsa Keir, PHARMD
• Lisa Keller
• Randall Lauren Keller, PH.D.
• Omar K Kelly
• Kenchanot, LLC
• Torian Raheem Kendall I
• Joseph Kennedy, M.S.ED
• Lilieth Angella Kerr-Santana

• Physician Assistant in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.