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JEREMY MACLAREN KELLY PHD
NPI 1548825078
Psychologist - Clinical in Pittsford, NY

Active since May 09, 2019PECOS Enrolled
179 SULLYS TRL STE 200, PITTSFORD, NY 14534(585) 276-6900(585) 273-1066 Get Directions Write a Review

NPPES record last updated: March 21, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 21, 2025, Nov 29, 2022, Oct 4, 2022 and 4 more (7 updates tracked since 2019).

About Jeremy Maclaren Kelly Phd NPPES

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

JEREMY MACLAREN KELLY PHD (NPI 1548825078) is an individual clinical provider in Pittsford, New York, licensed in New York (024880-01) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Geneseo.

NPPES Registry Identity

NPI1548825078
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJEREMY MACLAREN KELLYCredential: PHD
Location Address179 SULLYS TRL STE 200Pittsford, NY 14534-4500
Mailing Address300 Crittenden Blvd Box PsychRochester, NY 14642-0001 · (585) 276-6900
Phone(585) 276-6900
Fax(585) 273-1066
Sole ProprietorNo
Enumeration DateMay 9, 2019
Last NPPES UpdateMarch 21, 20257 updates tracked since enumeration
NPPES CertifiedMarch 21, 2025
✔ NPI 1548825078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in NY · 024880-01✔ Licensed in NY · 24880
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
179 SULLYS TRL STE 200, Pittsford, NY 14534
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Secondary Practice Location 1

Location 14 South StGeneseo, NY 14454-1310 · Phone (585) 770-7190

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeremy Maclaren Kelly Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Jeremy Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Rochester Department Of Psychiatry Clinical Group
9.3 mi
Psychiatry
300 CRITTENDEN BLVD
Rochester, NY 14642
  • Reassigned Medicare billing, New York enrollment
  • 191 clinicians in this Medicare group
NPI 1326088808 (585) 275-6733

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14534 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
$166.88 typical visit price
range $54.87 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Other Providers at the Same Location NPPES 6

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

ALLISON KANIA
Counselor (Mental Health)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301
DEBRA S. HOFFMAN PH.D.
Psychologist (Clinical)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301
LAWRENCE P PETERSON PHD
Psychologist (Clinical)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301
STEPHANIE LISA BERG MD
Psychiatry & Neurology (Psychiatry)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301
ADAM BROWNFELD PHD
Psychologist (Clinical)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301
GARY J. HORWITZ M.D.
Psychiatry & Neurology (Psychiatry)
179 SULLYS TRL STE 200
PITTSFORD, NY 14534
Monroe County (585) 275-7301

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 Jeremy Kelly's NPI number?

The NPI number for Jeremy Kelly is 1548825078. It was assigned to this individual provider in the NPPES registry on May 9, 2019.

Where is Jeremy Kelly located?

Jeremy Kelly practices at 179 Sullys Trl Ste 200, Pittsford, NY 14534. The listed phone number is (585) 276-6900.

What is Jeremy Kelly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeremy Kelly enrolled in Medicare?

Yes. Jeremy Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeremy Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Kelly reassigns Medicare benefits to University Of Rochester Department Of Psychiatry Clinical Group (Rochester, NY). The 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 Jeremy Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeremy Kelly was last updated on March 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.