Active NPI 1164758892 Individual Practitioner Male Practitioner

Dr. John Thomas Kelly , MD

General Practice • Boston, MA

Professional Overview & Biography Verified Profile Summary

Dr. John Kelly, MD is a registered healthcare professional specializing in General Practice in Boston, MA. Practice services are available at 175 BLOSSOM ST UNIT 1407 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

175 Blossom St Unit 1407

Boston, MA 021142629

Telephone 2155274684

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Boston, MA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 14.0 Yrs

State Avg: 30.7 Yrs

Regional Practice Density

17 Specialists

Practicing in Boston, MA (160 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-03-13

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License IL 036-077958

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Secondary Practice Locations

24 Brighton Ln

Oak Brook, IL 605232324

Phone: 2155274684

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

📍

Updated Practice Location January 21, 2023

Registered at 175 BLOSSOM ST UNIT 1407, BOSTON, MA 021142629 (Tel: 2155274684)

📍

Updated Business Mailing Address January 21, 2023

Registered at 175 BLOSSOM ST UNIT 1407, BOSTON, MA 021142629 (Tel: 2155274684)

📍

Updated Practice Location June 11, 2018

Registered at 2105 INTERLACKEN DR, SPRINGFIELD, IL 62704 (Tel: 2155274684)

📍

Updated Business Mailing Address June 11, 2018

Registered at PO BOX 13426, SPRINGFIELD, IL 627913426 (Tel: 2155274684)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 11, 2018

General Practice (License #036-077958 in IL)

✅

NPI Profile Active October 31, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location October 31, 2009

Registered at 900 BRYN MAWR AVE, PENN VALLEY, PA 190721404 (Tel: 2155274684)

📍

Updated Business Mailing Address October 31, 2009

Registered at PO BOX 780, PENN VALLEY, PA 190720780 (Tel: 2155274684)

👤

Provider Name / Credentials Updated October 31, 2009

Recorded as JOHN KELLY, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2009

Preventive Medicine (License #MD053323L in PA)

🟢

Initial NPI Registration & Enumeration October 31, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164758892

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 31, 2009

Last Update: March 13, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

175 Blossom St Unit 1407

Boston, MA 021142629

Phone: 2155274684

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.