Doctor profile · Federal record
Dr. Blaze Kelly, DO
Pain Medicine (Anesthesiology) Physician (CMS: Pain Management) · Student in an Organized Health Care Education/Training Program · Bridgeport, CT
- NPI 1003445842
- Accepts Medicare
- 6 yrs in practice
- Licensed in 2 states
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
267 Grant St
Bridgeport, CT 066102805
(203) 384-3000
fax (203) 384-4108 - Additional location
-
111 S 11Th St Ste 8290
Philadelphia, PA 191074824
(215) 955-2370
fax (215) 955-0677 - Mailing address
-
111 S 11Th St Ste 8290
Philadelphia, PA 191074824
Credentials & registration
- NPI registered
- April 2020 — 6 yrs on file
- Profile last updated
- May 16, 2025
- Year of graduation
- 2020 — 6 yrs since
- Specialty taxonomy
- 207LP2900X — NUCC code
- State licenses (2)
- Connecticut #81122 · Pennsylvania #OT019937
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1003445842. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$38
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Pacira Pharmaceuticals Incorporated | 1 | $37.80 |
By nature of payment
Frequently asked questions
What is Dr. Blaze Kelly's medical specialty?
Dr. Blaze Kelly practices Pain Medicine (Anesthesiology) Physician in Bridgeport, CT.
Where does Dr. Blaze Kelly practice?
Dr. Blaze Kelly practices at 267 Grant St, Bridgeport, CT 066102805. Office phone: 2033843000.
What is Dr. Blaze Kelly's NPI?
Dr. Blaze Kelly's National Provider Identifier (NPI) is 1003445842, issued by NPPES.
Does Dr. Blaze Kelly accept Medicare assignment?
Yes. Dr. Blaze Kelly accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.