MICHAEL KELLY D.O. NPI 1265583884

NPI Information

  • NPI: 1265583884
  • Provider Name: MICHAEL KELLY, D.O.
  • Classification: Internal Medicine - 207RS0010X
  • Specialization: Sports Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 776 NORTHFIELD AVE
    WEST ORANGE, NJ
    ZIP 07052
  • Phone: (973) 736-1939

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NPI Details

Michael Kelly, D.O. is a sports medicine internal medicine in West Orange, NJ with 25 years of experience. The provider is an internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual. Michael Kelly, D.O. NPI is 1265583884. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduation Year:2000

The provider's business location address is:

776 NORTHFIELD AVE
WEST ORANGE, NJ
ZIP 07052
Phone: (973) 736-1939
Fax: (973) 736-1937

The NPI 1265583884 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.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS:20611)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)

The enumeration date for this NPI number is 1/12/2007 and was last updated on 5/3/2024.

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
1207RS0010XInternal MedicineSports Medicine25MB07620900NEW JERSEYYes

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
1203812206OTHERNEW JERSEYTAX ID FOR SECOND OFFICE NJ SPORTS MEDICINE CENTER
27331613OTHERNEW JERSEYAETNA PROVIDER NUMBER
31619025038OTHERNEW JERSEYMEDICARE PIN SECOND OFFICE GROUP NUMBER
4P3389558OTHERNEW JERSEYOXFORD PROVIDER NUMBER

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: 3/30/2025

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