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MR. THOMAS JOSEPH KELLY IV
NPI 1871294801
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since March 16, 2023PECOS Enrolled
617 N 18TH ST APT 301, PHILADELPHIA, PA 19130(609) 947-6423 Get Directions Write a Review

NPPES record last updated: March 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Thomas Joseph Kelly Iv NPPES

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

MR. THOMAS JOSEPH KELLY IV (NPI 1871294801) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871294801
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. THOMAS JOSEPH KELLY IV
Location Address617 N 18TH ST APT 301Philadelphia, PA 19130-3389
Mailing Address4170 City AvePhiladelphia, PA 19131-1610 · (215) 871-6100
Phone(609) 947-6423
Sole ProprietorYes
Enumeration DateMarch 16, 2023
NPPES CertifiedMarch 16, 2023
✔ NPI 1871294801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
617 N 18TH ST APT 301, Philadelphia, PA 19130
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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. Thomas Joseph Kelly Iv 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.

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 Thomas Kelly's NPI number?

The NPI number for Thomas Kelly is 1871294801. It was assigned to this individual provider in the NPPES registry on March 16, 2023.

Where is Thomas Kelly located?

Thomas Kelly practices at 617 N 18th St Apt 301, Philadelphia, PA 19130. The listed phone number is (609) 947-6423.

What is Thomas Kelly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Thomas Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Thomas Kelly was last updated on March 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.