NPIMap

Individual provider Active NPI

Kelly Anthony Robinson, MD

  • Emergency Medicine Physician
  • Kenosha, WI
National Provider Identifier
1942266549
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
39518020 Issued in WI
Practice address
10400 75TH St
Aurora Medical Center
Kenosha, WI 53142
Phone
(262) 697-7000
Fax
(630) 734-1560
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 39518020 WI Primary

Addresses

Primary practice location

10400 75TH St
Aurora Medical Center
Kenosha, WI 53142

Mailing address

PO Box 3043
Mea Aea Kenosh SC
Oak Brook, IL 60522
Phone (630) 734-0200

Other identifiers 1

IdentifierTypeStateIssuer
32426800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161206000369 NJ Practitioner - Emergency Medicine 1759483233 Reassigns benefits to 5 organizations
I20180928000466 MA Practitioner - Emergency Medicine 1759483233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians
Ihpnj ER LLCGroup PAC ID 3870963168, 36 clinicians

Practice addresses (Care Compare)

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5000

29 E 29TH St
Bayonne, NJ 07002-4695
Phone (201) 858-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39518020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athol Memorial Hospital Incorporated Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince May 1, 2019 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Ihpnj ER LLC Emergency Medicine CurrentSince Jan 27, 2023 Accepting new patients
Henry Heywood Memorial Hospital Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Valley Emergency Assoc PA Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Garden State Healthcare Associates, LLC Emergency Medicine CurrentSince Nov 3, 2017 Accepting new patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
Mea-Aea Kenosha SC Emergency Medicine Past Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: krobinson43780@direct.southcoast.org

Organizations & group practices 10

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 5

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1942266549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3043",
            "address_2": "MEA AEA KENOSH SC",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60522",
            "telephone_number": "630-734-0200",
            "fax_number": "630-734-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "address_2": "AURORA MEDICAL CENTER",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-697-7000",
            "fax_number": "630-734-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KELLY",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "39518020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32426800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.