JOHN EDWARD KELLY MD PA
NPI 1407158850
Family Medicine in Rockville, MD
About John Edward Kelly Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN EDWARD KELLY MD PA (NPI 1407158850) is a healthcare organization registered as a family medicine in Rockville, Maryland and active in the NPI registry since November 2010. The organization lists John Edward Kelly, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John Edward Kelly Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to John Edward Kelly MD PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 John Edward Kelly MD PA's NPI number?
The NPI number for John Edward Kelly MD PA is 1407158850. It was assigned to this organization in the NPPES registry on November 17, 2010.
Where is John Edward Kelly MD PA located?
John Edward Kelly MD PA is located at 2401 Research Blvd Ste 340, Rockville, MD 20850. The listed phone number is (301) 212-9200.
What is John Edward Kelly MD PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is John Edward Kelly MD PA enrolled in Medicare?
Yes. John Edward Kelly MD PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through John Edward Kelly MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to John Edward Kelly MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for John Edward Kelly MD PA was last updated on December 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# John Edward Kelly Md Pa · NPI 1407158850
Family Medicine organization in Rockville, Maryland. Organization record, active in the CMS NPPES registry since November 17, 2010.
## Identity
- **NPI:** 1407158850 (Entity type: Organization)
- **Enumerated:** November 17, 2010
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** John Kelly, PRESIDENT
## Practice location
- **Address:** 2401 RESEARCH BLVD STE 340, Rockville, MD 20850-6254
- **Phone:** (301) 212-9200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 15, 2010
- **Other identifiers:** Medicaid 113251200 (MD); Medicare UPIN D09446 (MD); Medicare PIN KE173065 (MD)
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Source: [NPI Profile](https://npiprofile.com/npi/1407158850) · Data from the CMS NPPES public registry.