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CARMEL M KELLY MD NPI 1164416228


NPI Information

NPI: 1164416228
Provider Name: CARMEL M KELLY, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 22D0967886

Address:
1093 N MAIN ST
RANDOLPH, MA
ZIP 02368
Phone: (781) 963-0676
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Carmel M Kelly, MD is a family medicine in Randolph, MA with 44 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Carmel M Kelly, MD NPI is 1164416228. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1093 N MAIN ST
RANDOLPH, MA
ZIP 02368-100
Phone: (781) 963-0676
Fax: (781) 963-7417

The NPI 1164416228 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 CLIA number assigned to this NPI record is 22D0967886 - physician office with a certificate type of Certificate of Waiver.

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.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Urinalysis, manual test (HCPCS:81002)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 9/6/2005 and was last updated on 4/7/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine57521MASSACHUSETTSYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10100052OTHEREVERCARE
2M15986OTHERBLUE CROSS INDEMNITY
3J06362OTHERHMO BLUE
4043243146OTHERGREAT WEST HEALTHCARE
5B74808MEDICARE UPIN
664506OTHERHARVARD PILGRIM
73022447MEDICAIDMASSACHUSETTS
80100918OTHERNEBRASKAUNITED HLTHCARE OF NE
9043243146OTHERHCVM
10043243146OTHERUNICARE
11J06362OTHERBLUE CROSS INDEMNITY
12J06362MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
13M15986MEDICARE ID-TYPE UNSPECIFIED
143567516OTHERAETNA HEALTH PLAN
15043243146MEDICARE ID-TYPE UNSPECIFIEDPREFERRED TUFTS
16080156922MEDICARE ID-TYPE UNSPECIFIEDRR
17J06362OTHERBLUE CARE ELECT
187134757002OTHERCIGNA
19043243146OTHERHARVARD PILGRIM
2021003084366OTHERBEECH STREET

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.