SEAN MICHAEL KELLY GNP-BC
NPI 1215378740
Nurse Practitioner - Gerontology in New York, NY

Q: What is Sean Kelly's NPI number?

The NPI number for Sean Kelly is 1215378740. It was assigned to this individual provider in the NPPES registry on July 12, 2013.

Q: What is Sean Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Sean Kelly was last updated on October 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since July 12, 2013PECOS Enrolled

1 PENN PLZ FL 8, NEW YORK, NY 10119(347) 213-8011 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 29, 2020, Oct 12, 2018 (2 updates tracked since 2018).

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About Sean Michael Kelly Gnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN MICHAEL KELLY GNP-BC (NPI 1215378740) is an individual gerontology provider in New York, New York, licensed in New York (340958) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Lisle.

NPPES Registry Identity

NPI1215378740

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameSEAN MICHAEL KELLYCredential: GNP-BC

Location Address1 PENN PLZ FL 8New York, NY 10119-0899

Mailing Address120 W 106th St OfcNew York, NY 10025-3923 · (347) 501-2299

Phone(347) 213-8011

Sole ProprietorNo

Enumeration DateJuly 12, 2013

Last NPPES UpdateOctober 29, 20202 updates tracked since enumeration

NPPES CertifiedOctober 29, 2020

✔ NPI 1215378740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in NY · 340958

1 PENN PLZ FL 8, New York, NY 10119

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Secondary Practice Location 1

Location 1550 Warrenville Rd, Suite 300Lisle, IL 60532-4308 · Phone (773) 332-9616

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sean Michael Kelly Gnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10119 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VIVIAN MIN-LAN CHEN NP

Nurse Practitioner (Family)