Individual provider Active NPI

Maureen Kelly, M.D.

  • Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1942367461
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD047210L Issued in PA
Practice address
815 Locust St
Philadelphia, PA 19107-5504
Phone
(215) 922-2066
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X MD047210L PA
Gynecology Physician 207VG0400X MD047210L PA Primary

Addresses

Primary practice location

815 Locust St
Philadelphia, PA 19107-5504

Mailing address

815 Locust St
Philadelphia, PA 19107-5504
Phone (215) 922-2066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000040 PA Practitioner - Obstetrics/GynecologyPractitioner - Endocrinology 6305934001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047210LPAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reproductive Associates of Delaware Reproductive Endocrinology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maureen.kelly.1@17469.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1942367461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075504",
            "telephone_number": "215-922-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075504",
            "telephone_number": "215-922-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "PA",
            "license": "MD047210L",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PA",
            "license": "MD047210L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.