1. Home
  2. Directory
  3. Pennsylvania
  4. Philadelphia
  5. Pediatrics
  6. NPI Profile

JESSICA KELLY MD
NPI 1760973416
Pediatrics - Pediatric Emergency Medicine in Philadelphia, PA

Active since May 29, 2018PECOS Enrolled
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 590-1000 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Jun 23, 2021, Jun 14, 2021 (2 updates tracked since 2021).

About Jessica Kelly Md NPPES

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

JESSICA KELLY MD (NPI 1760973416) is an individual pediatric emergency medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT222159) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Providence.

NPPES Registry Identity

NPI1760973416
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameJESSICA KELLYCredential: MD
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address3401 Civic Center BlvdPhiladelphia, PA 19104-4319 · (215) 590-3498
Phone(215) 590-1000
Sole ProprietorNo
Enumeration DateMay 29, 2018
Last NPPES UpdateJune 23, 20212 updates tracked since enumeration
NPPES CertifiedJune 23, 2021
✔ NPI 1760973416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in PA · MT222159
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License LP04242 (RI)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
Open in Google Maps ↗

Secondary Practice Location 1

Location 1593 Eddy StProvidence, RI 02903-4923 · Phone (401) 444-7574

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Kelly Md 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.

Other Providers at the Same Location NPPES 20

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

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Jessica Kelly's NPI number?

The NPI number for Jessica Kelly is 1760973416. It was assigned to this individual provider in the NPPES registry on May 29, 2018.

Where is Jessica Kelly located?

Jessica Kelly practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-1000.

What is Jessica Kelly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Jessica Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jessica Kelly was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.