Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tia Ann-Patrice Kellman, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1972230779

Tia Ann-Patrice Kellman, AGACNP-BC is a Nurse Practitioner in New York, New York. Qualified in 2022, 4 years ago. Practices with MSKCC Surgery Group, a 365-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

1275 York Ave
New York, NY 10065-6007
Phone: (212) 639-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence F432340 (NY)

Record details

NPI number1972230779
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedAugust 2, 2022
Last updated in NPPESOctober 19, 2022
Certification dateOctober 19, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mskcc Surgery Group — 365 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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