NPIMap

Individual provider Active NPI

Patrick Anthony Kelleher, MD

  • Internal Medicine Physician
  • Berea, KY
National Provider Identifier
1952345522
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20629 Issued in KY
Practice address
1036 Ace Dr
Berea, KY 40403-1327
Phone
(859) 986-3124
NPI assigned
Jun 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Internal Medicine Physician 207R00000X 20629 KY Primary

Addresses

Primary practice location

1036 Ace Dr
Berea, KY 40403-1327

Mailing address

1036 Ace Dr
Berea, KY 40403-1327
Phone (859) 986-3124

Other identifiers 1

IdentifierTypeStateIssuer
65908998MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040629000070 KY Practitioner - Internal MedicinePractitioner - Emergency Medicine 9931185006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berea Clinic of Internal Medicine PSCGroup PAC ID 7113975343, 2 clinicians
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians

Practice addresses (Care Compare)

1036 Ace Dr
Berea, KY 40403-1327
Phone (859) 986-3124

116 Meridian Way
Suite 9
Richmond, KY 40475-2876
Phone (859) 623-6334

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince May 27, 2017 Accepting new patients
Berea Clinic of Internal Medicine, PSC CurrentSince Oct 1, 1984 Accepting new patients
Saint Joseph Health System, Inc. PastSince Feb 10, 1996 Accepting new patients

Locations

1036 Ace Dr
Berea, KY 40403
Phone (859) 986-3124

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16662/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patrick.kelleher.1@16662.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952345522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 ACE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031327",
            "telephone_number": "859-986-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 ACE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031327",
            "telephone_number": "859-986-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "PATRICK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "20629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65908998",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.