MARY MICHAEL KELLEY PA-C NPI 1689608275

NPI Information

  • NPI: 1689608275
  • Provider Name: MARY MICHAEL KELLEY, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • Address: 396 BROADWAY
    KINGSTON, NY
    ZIP 12401
  • Phone: (845) 334-2890

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NPI Details

Mary Michael Kelley, PA-C is a physician assistant in Kingston, NY. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Mary Michael Kelley, PA-C NPI is 1689608275. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

396 BROADWAY
KINGSTON, NY
ZIP 12401-626
Phone: (845) 334-2890

The enumeration date for this NPI number is 7/10/2006 and was last updated on 7/12/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant007123NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15F5551MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
2364664OTHERNEW YORKMVP
3P25686MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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