Timothy Stephen Kelly, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD484814 Issued in PA

Practice address

700 Spruce Street
Pine Basement West
Philadelphia, PA 19106-4022

Phone

(215) 829-3358

Fax

(215) 829-3438

NPI assigned

Mar 25, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Washington School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment Care Compare group NPD
• University of Penn-Medical Group

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1255729364
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1073140497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064022",
            "telephone_number": "215-829-3358",
            "fax_number": "215-829-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "PINE BASEMENT WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064022",
            "telephone_number": "215-829-3358",
            "fax_number": "215-829-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TIMOTHY",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "PA",
            "license": "MD484814",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD484814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Schack Kelly, PHD
• Thomas Joseph Kelly IV
• Thomas M Kelly, CRNA
• Timothy Joseph Johnson Kelly, MD
• Timothy Patrick Kelly, LPC
• Vincent Joseph Kelly Jr., PHARMD, RPH
• William Kelly, CRNA
• William Kevin Kelly, DO
• Todd Marc Kelman, D.O.
• Samuel Kelokates, D.P.T

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.