Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Siobhan Elizabeth Kelly

Individual provider Nurse Practitioner · NPI 1679349211

Siobhan Elizabeth Kelly is a Nurse Practitioner in Boston, Massachusetts. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Massachusetts.

Years since qualifying
1
Licensed in
MA
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

55 Fruit St
Boston, MA 02241-9095
Phone: (617) 726-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN2340465 (MA)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence RN2340465 (MA)
Administrator Registered Nurse Taxonomy 163WA2000X · Licence RN2340465 (MA)

Record details

NPI number1679349211
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 27, 2023
Last updated in NPPESFebruary 25, 2026
Certification dateFebruary 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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