MARY MARGARET KELLY APN
NPI 1972691079
Nurse Practitioner - Adult Health in Lodi, NJ
About Mary Margaret Kelly Apn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY MARGARET KELLY APN (NPI 1972691079) is an individual adult health provider in Lodi, New Jersey, licensed in New Jersey (26NN04298100) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Hackensack.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Margaret Kelly Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Red Bank, NJ 07701
- Reassigned Medicare billing, New Jersey enrollment
- 2,844 clinicians in this Medicare group
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 07644 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LODI, NJ 07644
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 Mary Kelly's NPI number?
The NPI number for Mary Kelly is 1972691079. It was assigned to this individual provider in the NPPES registry on October 11, 2006.
Where is Mary Kelly located?
Mary Kelly practices at 116 Terrace Ave, Lodi, NJ 07644. The listed phone number is (973) 473-3896.
What is Mary Kelly's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Mary Kelly enrolled in Medicare?
Yes. Mary Kelly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Kelly reassigns Medicare benefits to Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). 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 Mary 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 Mary Kelly was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mary Margaret Kelly, APN · NPI 1972691079
Adult Health physician in Lodi, New Jersey. Individual provider, active in the CMS NPPES registry since October 11, 2006.
## Identity
- **NPI:** 1972691079 (Entity type: Individual)
- **Enumerated:** October 11, 2006
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 26NN04298100 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 116 TERRACE AVE, Lodi, NJ 07644-2905
- **Phone:** (973) 473-3896
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Hackensack Meridian Health Medical Group - Specialty Care PC (NPI 1215989249, Red Bank, NJ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1972691079) · Data from the CMS NPPES public registry.