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MR. JOHN P KELLY RPA
NPI 1558704775
Physician Assistant - Medical in Massapequa, NY

Active since April 08, 2013PECOS Enrolled
515 BROADWAY, MASSAPEQUA, NY 11758(516) 799-2700(516) 799-8023 Get Directions Write a Review

NPPES record last updated: April 8, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. John P Kelly Rpa NPPES

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

MR. JOHN P KELLY RPA (NPI 1558704775) is an individual medical provider in Massapequa, New York, licensed in New York (007491) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558704775
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. JOHN P KELLYCredential: RPA
Location Address515 BROADWAYMassapequa, NY 11758-5005
Mailing Address515 BroadwayMassapequa, NY 11758-5005 · (516) 799-2700 · Fax (516) 799-8023
Phone(516) 799-2700
Fax(516) 799-8023
Sole ProprietorNo
Enumeration DateApril 8, 2013
✔ NPI 1558704775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 007491
515 BROADWAY, Massapequa, NY 11758
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. John P Kelly Rpa 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers12 claims23 services$4.00 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

NEIL J DASH MD PC
Internal Medicine
515 BROADWAY
MASSAPEQUA, NY 11758
Nassau County (516) 799-2700
MICHAEL HOFFMAN RPA
Physician Assistant
515 BROADWAY
MASSAPEQUA, NY 11758
Nassau County (516) 799-2700
AYESHA MANNAN DO
Family Medicine
515 BROADWAY
MASSAPEQUA, NY 11758
Nassau County (631) 667-0388
DR. NEIL JEFFREY DASH M.D.
Internal Medicine
515 BROADWAY
MASSAPEQUA, NY 11758
Nassau County (516) 799-2700

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 Kelly's NPI number?

The NPI number for John Kelly is 1558704775. It was assigned to this individual provider in the NPPES registry on April 8, 2013.

Where is John Kelly located?

John Kelly practices at 515 Broadway, Massapequa, NY 11758. The listed phone number is (516) 799-2700.

What is John Kelly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is John Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for John Kelly was last updated on April 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.