MS. KELLY ANN GROOM M.S. PA-C
NPI 1740302421
Physician Assistant - Medical in Bronx, NY

Q: What is Kelly Groom's NPI number?

The NPI number for Kelly Groom is 1740302421. It was assigned to this individual provider in the NPPES registry on April 4, 2007.

Q: What is Kelly Groom's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Groom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since April 04, 2007PECOS EnrolledAccepts Medicare Assignment

1803 MAHAN AVE, BRONX, NY 10461(718) 409-2762(718) 863-4432 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

On this page

About Ms. Kelly Ann Groom M.s. Pa-c NPPES

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

MS. KELLY ANN GROOM M.S. PA-C (NPI 1740302421) is an individual medical provider in Bronx, New York, licensed in New York (009403) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2003).

NPPES Registry Identity

NPI1740302421

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. KELLY ANN GROOMCredential: M.S. PA-C

Location Address1803 MAHAN AVEBronx, NY 10461-4621

Mailing Address222 E 34th St, Apartment #1203New York, NY 10016-4842

Phone(718) 409-2762

Fax(718) 863-4432

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateApril 4, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1740302421 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 · 009403

1803 MAHAN AVE, Bronx, NY 10461

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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 and accepts Medicare assignment

Ms. Kelly Ann Groom M.s. Pa-c 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 ID9739625039

PECOS Enrollment IDI20240723002611

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

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.

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.

23 services22 patients

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.

MARY JOY RUIZ PT,DPT

Physical Therapist

1803 MAHAN AVE
BRONX, NY 10461

Bronx County (917) 816-6423

MR. CHI KEI LEE PT

Physical Therapist

1803 MAHAN AVE
BRONX, NY 10461

Bronx County (917) 816-6423

INTERAKTIVE REHAB PHYSICAL THERAPY, P.C.

Physical Therapist

1803 MAHAN AVE
BRONX, NY 10461

Bronx County (917) 816-6423

METRO PHYSICIAN ASSOCIATES LLP

Nuclear Medicine (Nuclear Cardiology)

1803 MAHAN AVE
BRONX, NY 10461

Bronx County (212) 475-8066

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 Kelly Groom's NPI number?

The NPI number for Kelly Groom is 1740302421. It was assigned to this individual provider in the NPPES registry on April 4, 2007.

Where is Kelly Groom located?

Kelly Groom practices at 1803 Mahan Ave, Bronx, NY 10461. The listed phone number is (718) 409-2762.

What is Kelly Groom's specialty?

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

Is Kelly Groom enrolled in Medicare?

Yes. Kelly Groom 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.

When was this NPI record last updated?

The NPPES record for Kelly Groom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.