Robert Emmett Kelly Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

237480 Issued in NY

Practice address

21 Bloomingdale Rd
White Plains, NY 10605-1504

Phone

(646) 763-7210

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rek2005@direct.nyp.org

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.

• The New York and Presbyterian Hospital

  • Nutritionist
  • New York, NY
  • NPI 1891857025
  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Psychologist
  • New York, NY
  • NPI 1871692210
  Medicare reassignment NPD
• New York and Presbyterian Hosp

  • Psychiatry Physician
  • New York, NY
  • NPI 1912173329
  NPD
• The New York and Presbyterian Hospital

  • Community/Retail Pharmacy
  • White Plains, NY
  • NPI 1457057226
  NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1992827117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BLOOMINGDALE RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051504",
            "telephone_number": "646-763-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BLOOMINGDALE RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051504",
            "telephone_number": "646-763-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBERT",
        "middle_name": "EMMETT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "237480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizbeth Keller Jones, ACNP
• Carol Ann Kelly, FNP
• Erica Kelly, LPN
• Jennifer Lauren Kelly
• Laura Alexandra Kelly, DPT
• Johnetta Massah Kemoh
• Karen Ann Kennedy, APN-BC
• Magen T Kennedy, MPT
• Laniyah Bryanna Kenner
• Alyce Kenney

• Psychiatry Physician in White Plains, NY
• Providers in White Plains, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.