JOHN S KELLY MD NPI 1033104849

NPI Information

  • NPI: 1033104849
  • Provider Name: JOHN S KELLY, MD
  • Classification: Internal Medicine - 207RG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 710 FRANKLIN ST
    SUITE 200
    MICHIGAN CITY, IN
    ZIP 46360
  • Phone: (219) 872-6200

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NPI Details

John S Kelly, MD is a geriatric medicine internal medicine in Michigan City, IN with 54 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. John S Kelly, MD NPI is 1033104849. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1972

The provider's business location address is:

710 FRANKLIN ST
SUITE 200
MICHIGAN CITY, IN
ZIP 46360-563
Phone: (219) 872-6200
Fax: (219) 879-2915

The NPI 1033104849 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
  • Hemoglobin a1c level (HCPCS:83036)
  • Routine electrocardiogram (ecg) using at least 12 leads with tracing (HCPCS:93005)
  • Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) (HCPCS:87811)

The enumeration date for this NPI number is 9/19/2005 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric Medicine01024423AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200030090MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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