MICHAEL KELLY D.O.
NPI 1265583884
Internal Medicine - Sports Medicine in West Orange, NJ
NPI Status: Active since January 12, 2007
Contact Information
622 EAGLE ROCK AVE
SUITE 305
WEST ORANGE, NJ
ZIP 07052
Phone: (973) 736-1939
Fax: (973) 736-1937
- Individual
- Male
- Years of Experience 26
- Internal Medicine
- Sports Medicine
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL KELLY
This page provides the complete NPI Profile along with additional information for Michael Kelly, an internist established in West Orange, New Jersey with a medical specialization in Internal Medicine, focusing in sports medicine and more than 26 years of experience. He graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2000. The healthcare provider is registered in the NPI registry with number 1265583884 assigned on January 2007. The practitioner's primary taxonomy code is 207RS0010X with license number 25MB07620900 (NJ). The provider is registered as an individual and his NPI record was last updated March 2026.
- NPI
- 1265583884
- Provider Name
- MICHAEL KELLY D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 622 EAGLE ROCK AVE SUITE 305 WEST ORANGE, NJ 07052
- Location Phone
- (973) 736-1939
- Location Fax
- (973) 736-1937
- Mailing Address
- 622 EAGLE ROCK AVE SUITE 305 WEST ORANGE, NJ 07052
- Mailing Phone
- (973) 736-1939
- Mailing Fax
- (973) 736-1937
- Medical School Name
- NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
- Graduation Year
- 2000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-12-2007
- Last Update Date
- 03-16-2026
- Code Navigator
An internist like Michael Kelly is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Sports Medicine
- Taxonomy Code
- 207RS0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MB07620900
- License State
- NJ
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 203812206 | OTHER (01) | NJ | TAX ID FOR SECOND OFFICE NJ SPORTS MEDICINE CENTER |
| 7331613 | OTHER (01) | NJ | AETNA PROVIDER NUMBER |
| 1619025038 | OTHER (01) | NJ | MEDICARE PIN SECOND OFFICE GROUP NUMBER |
| P3389558 | OTHER (01) | NJ | OXFORD PROVIDER NUMBER |
Medicare Participation & PECOS Enrollment Status
Michael Kelly is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Kelly is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 2567424385
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20041103000122
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Aspiration and/or injection of fluid large joint using ultrasound guidance
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection, methylprednisolone acetate, 80 mg
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 12 times for 11 patientsThis 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.
This service was performed 79 times for 26 patientsThis 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.
This service was performed 89 times for 43 patientsThis 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.
This service was performed 41 times for 30 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 43 times for 28 patientsReviews for MICHAEL KELLY D.O.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1265583884, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WEST ORANGE, NJ 07052
WEST ORANGE, NJ 07052
WEST ORANGE, NJ 07052
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265583884, enumerated as an "individual" on January 12, 2007.
The provider is located at 622 EAGLE ROCK AVE SUITE 305 WEST ORANGE, NJ 07052 and the phone number is (973) 736-1939.
Internal Medicine with taxonomy code 207RS0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Medicare, Medicaid, Aetna and Oxford Health Plans. Please consult your insurance carrier or call the provider to verify.