MICHAEL KELLY (NPI# 1265583884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265583884 |
| Entity Type | Individual |
| Full Name | MICHAEL KELLY |
| Credential | D.O. |
| Practice Address |
124 E Mount Pleasant Ave Livingston NJ 07039-3026 |
| Practice Telephone | 9735358300 |
| Practice Fax Number | 9735356334 |
| Mailing Telephone | 9735358300 |
| Mailing Fax Number | 9735356334 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
25MB07620900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | TAX ID FOR SECOND OFFICE NJ SPORTS MEDICINE CENTER | 203812206 | 01 |
| NJ | AETNA PROVIDER NUMBER | 7331613 | 01 |
| NJ | MEDICARE PIN SECOND OFFICE GROUP NUMBER | 1619025038 | 01 |
| NJ | OXFORD PROVIDER NUMBER | P3389558 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389874 | Michael Kelly | Physical Therapist | 1025 Service Pl Ste 200, Vista, CA 92084-7271 | 2020-09-03 |
| 1871949115 | Michael John Kelly | Speech-Language Pathologist | 3484 Fair Oaks Ave, Bowling Green, KY 42104-5529 | 2016-05-05 |
| 1003206004 | Michael Sean Kelly | Nurse Practitioner | 17601 17th St Ste 120, Tustin, CA 92780-1946 | 2015-01-28 |
| 1295135515 | Michael Kelly | Technician, Other | 2215 E 36 1/2 St, Minneapolis, MN 55407-3018 | 2014-08-25 |
| 1225310675 | Michael Thomas Kelly | Pathology | 4156 H Street Rd, Blaine, WA 98230-9228 | 2011-09-12 |
| 1205085073 | Michael H Kelly | Massage Therapist | 76 Bosse Ln, West Seneca, NY 14224-1624 | 2008-09-16 |
| 1275780041 | Michael Foster Kelly | Acupuncturist | 8 Wells Ave, Yonkers, NY 10701-2710 | 2008-08-25 |
| 1346458031 | Michael Francis Kelly | Registered Nurse | 79 Trausneck Pl, Yonkers, NY 10703-1907 | 2007-05-18 |
| 1104045707 | Michael Walter Kelly | Pharmacist | College of Pharmacy, 110 Pharmacy Building, Iowa City, IA 52242-1112 | 2007-04-24 |
| 1710105358 | Michael Kelly | Physical Therapist | 1600 E. Jefferson St., Seattle, WA 98122 | 2007-04-20 |
| Street Address |
124 E MOUNT PLEASANT AVE |
| City | LIVINGSTON |
| State | NJ |
| Zip Code | 07039-3026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474308 | Martin Jay Greenberg | Internal Medicine | 124 E Mount Pleasant Ave, Livingston, NJ 07039-3026 | 2005-08-19 |
| 1265669378 | Debra Shapiro Gill | Psychologist | 124 E Mount Pleasant Ave, Livingston, NJ 07039-3026 | 2009-06-16 |
| 1386826832 | Alan B Levine D C P A | Chiropractor | 124 E Mount Pleasant Ave, Livingston, NJ 07039-3026 | 2007-11-27 |
| 1184830655 | Eric Marshall Sacks | Dentist | 124 E Mount Pleasant Ave, Livingston, NJ 07039-3026 | 2007-05-14 |
| 1669590923 | Ma'ayan Greenbaum | Psychologist | 124 E Mount Pleasant Ave, 2nd Fl, Livingston, NJ 07039-3026 | 2007-03-26 |
| 1093804973 | Alan Bernard Levine | Chiropractor | 124 E Mount Pleasant Ave, Livingston, NJ 07039-3026 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184111 | Dentistry With A Smile, Inc. | Durable Medical Equipment & Medical Supplies | 1100 Town Center Way, 14-a-ii, Livingston, NJ 07039 | 2020-11-03 |
| 1326692104 | Amy Beth Lipsey | Social Worker | Amy Lipsey, 301 South Livingston Avenue, Livingston, NJ 07039 | 2019-07-30 |
| 1427543412 | Bodypro Physical Therapy, LLC | Physical Therapist | 5 Country Club Ct, Livingston, NJ 07039 | 2018-06-22 |
| 1538665245 | Kushal Shukla | Student in an Organized Health Care Education/Training Program | 20 Canoe Brook Dr, Livingston, NJ 07039 | 2018-04-02 |
| 1629594643 | Northeast Pulmonary and Sleep Medical LLC | Specialist | 506 Regent Street, Suite A, Livingston, NJ 07039 | 2017-08-22 |
| 1184154098 | Snf Old Short Hills Operating Company, LLC | Skilled Nursing Facility | 348 East Cedar Street, Livingston, NJ 07039 | 2017-06-13 |
| 1093254690 | Suzanne M Verbesky Dpm LLC | Clinic/Center | 44 West Mcclellan Avenue, Livingston, NJ 07039 | 2017-02-15 |
| 1649723743 | Essex County Weightloss, LLC | Internal Medicine | 5 Regent St Ste 509, Livingston, NJ 07039 | 2016-07-26 |
| 1912352824 | Grant Arzumanov | Student in an Organized Health Care Education/Training Program | 94 Old Short Hills Rd., Livingston, NJ 07039 | 2016-04-28 |
| 1891158671 | Journey's Eve Counseling LLC | Counselor | 2 Northfield Rd, 210a, Livingston, NJ 07039 | 2016-03-30 |
| Find all providers in zip 07039 | ||||
| Taxonomy Code | 207RS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sports Medicine |
| An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699869297 | Amg-livingston LLC | Internal Medicine | 506 W Main St, Livingston, TN 38570-1718 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457843070 | Njnyc Health Hub LLC | Internal Medicine | 851 Franklin Lake Rd Ste 33, Franklin Lakes, NJ 07417-2266 | 2018-05-30 |
| 1750895900 | Riverside Preventative Health LLC | Internal Medicine | 1 Journal Square Plz Ste 303, Jersey City, NJ 07306-4004 | 2017-11-27 |
| 1306229943 | Atlantic Sports Medicine LLC | Internal Medicine | 8 Brian Ct, Farmingdale, NJ 07727-4205 | 2015-07-01 |
| 1841602281 | Zachary K Perlman | Internal Medicine | 804 West Park Ave, Building B. Suite 201, Ocean Township, NJ 07721 | 2014-05-20 |
| 1386816056 | Sports Medicine New Jersey Pa | Internal Medicine | 475 County Road, Suite 520, Marlboro, NJ 07746-1059 | 2008-04-02 |
| 1588693915 | Robert Emmit Ward | Internal Medicine | 806 Fownes Ave, Brigantine, NJ 08203-3033 | 2006-06-30 |
| 1487682654 | James J Mauti | Internal Medicine | 406 Milltown Rd, Springfield, NJ 07081-2445 | 2006-06-28 |
| 1497751242 | Andrew L. Nelson | Internal Medicine | 1594 Route 9, Unit 6, Toms River, NJ 08755 | 2005-06-27 |
| 1932737525 | Kai Sports Medicine LLC | Internal Medicine | 804 West Park Ave, Building B. Suite 201, Ocean Township, NJ 07712 | 2020-03-30 |
| 1346808045 | Tri-state Specialists | Internal Medicine | 116 S Euclid Ave, Westfield, NJ 07090-2184 | 2019-05-29 |
| Find all providers with the same taxonomy | ||||
| City | LIVINGSTON |
| Zip Code | 07039 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.