ANDREW NICHOLAS KELLY PA-C
NPI 1104356377
Physician Assistant - Medical in New York, NY
About Andrew Nicholas Kelly Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW NICHOLAS KELLY PA-C (NPI 1104356377) is an individual medical provider in New York, New York, licensed in New York (024491) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Andrew Nicholas Kelly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Kelly's NPI number?
The NPI number for Andrew Kelly is 1104356377. It was assigned to this individual provider in the NPPES registry on June 19, 2017.
Where is Andrew Kelly located?
Andrew Kelly practices at 589 3rd Ave, New York, NY 10016. The listed phone number is (212) 658-6791.
What is Andrew Kelly's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Andrew Kelly enrolled in Medicare?
Yes. Andrew Kelly is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Andrew Kelly was last updated on March 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andrew Nicholas Kelly, PA-C · NPI 1104356377
Medical physician in New York, New York. Individual provider, active in the CMS NPPES registry since June 19, 2017.
## Identity
- **NPI:** 1104356377 (Entity type: Individual)
- **Enumerated:** June 19, 2017
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 024491 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 589 3RD AVE, New York, NY 10016-2711
- **Phone:** (212) 658-6791 · **Fax:** (212) 867-4353
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104356377) · Data from the CMS NPPES public registry.