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MICHAEL KELLY D.O.
NPI 1265583884
Internal Medicine - Sports Medicine in West Orange, NJ

Active since January 12, 2007PECOS EnrolledAccepts Medicare Assignment
622 EAGLE ROCK AVE, SUITE 305, WEST ORANGE, NJ 07052(973) 736-1939(973) 736-1937 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2026, May 3, 2024 (2 updates tracked since 2024).

About Michael Kelly D.o. NPPES

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

MICHAEL KELLY D.O. (NPI 1265583884) is an individual sports medicine provider in West Orange, New Jersey, licensed in New Jersey (25MB07620900) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with St Joseph's University Medical Center Inc, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2000).

NPPES Registry Identity

NPI1265583884
Entity TypeIndividualMale
Primary Taxonomy207RS0010X
Provider Legal NameMICHAEL KELLYCredential: D.O.
Location Address622 EAGLE ROCK AVE, SUITE 305West Orange, NJ 07052
Mailing Address622 Eagle Rock Ave, Suite 305West Orange, NJ 07052 · (973) 736-1939 · Fax (973) 736-1937
Phone(973) 736-1939
Fax(973) 736-1937
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2000
Enumeration DateJanuary 12, 2007
Last NPPES UpdateMarch 16, 20262 updates tracked since enumeration
NPPES CertifiedMarch 16, 2026
✔ NPI 1265583884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0010X
License✔ Licensed in NJ · 25MB07620900
Definition
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.
622 EAGLE ROCK AVE, West Orange, NJ 07052
Open in Google Maps ↗

Other Identifiers 4

Other203812206NJ · Tax Id For Second Office Nj Sports Medicine Center
Other7331613NJ · Aetna Provider Number
Other1619025038NJ · Medicare Pin Second Office Group Number
OtherP3389558NJ · Oxford Provider Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Kelly D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567424385
PECOS Enrollment IDI20041103000122
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
113 services37 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
105 services51 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
44 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number310019
Location703 Main StPaterson, NJ 07503 · Passaic County
Birthing friendly

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.

JAG PEDIATRIC THERAPY
Clinic/Center (Physical Therapy)
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 669-0072
MS. TAYLOR BRIER ALDA ATC
Specialist/Technologist (Athletic Trainer)
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 669-0048
RAPHAEL MORENO
Physical Therapist
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 669-0078
MISS ERIN M QUINN PTA
Physical Therapy Assistant
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 669-0078
NICHOLAS DALONZO PT, DPT
Physical Therapist
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 669-0078
BRIAN CALVIN MARTIN DDS
Dentist (General Practice)
622 EAGLE ROCK AVE, SUITE 105
WEST ORANGE, NJ 07052
Essex County (973) 325-1011
DR. JOEL F DAVIS DDS
Dentist (General Practice)
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-2262
ENDEAVORS IN LIVING
Counselor (Professional)
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052
Essex County (973) 876-8686

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 Michael Kelly's NPI number?

The NPI number for Michael Kelly is 1265583884. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Michael Kelly located?

Michael Kelly practices at 622 Eagle Rock Ave Suite 305, West Orange, NJ 07052. The listed phone number is (973) 736-1939.

What is Michael Kelly's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Is Michael Kelly enrolled in Medicare?

Yes. Michael Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Michael Kelly affiliated with any hospitals?

According to CMS data, Michael Kelly is affiliated with St Joseph's University Medical Center Inc.

When was this NPI record last updated?

The NPPES record for Michael Kelly was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.