Individual provider Active NPI

Kate Elizabeth Kiely, MD

  • Vascular Surgery Physician
  • Fresno, CA
National Provider Identifier
1083061253
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A186890 Issued in CA
Practice address
1247 E Alluvial Ave Ste 101
Fresno, CA 93720-2686
Phone
(559) 431-6226
Fax
(559) 440-9005
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A186890 CA Primary

Addresses

Primary practice location

1247 E Alluvial Ave Ste 101
Fresno, CA 93720-2686

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Other names 1

  • Dr. Kate Elizabeth Kiely Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230831002448 CA Practitioner - Vascular Surgery 6608270459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central California Faculty Medical Group IncGroup PAC ID 8325952773, 256 clinicians

Practice addresses (Care Compare)

1247 E Alluvial Ave
Suite 101
Fresno, CA 93720-2686
Phone (559) 431-6226

Hospital & facility affiliations

  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal47
Leg revascularization (restoring blood flow)31
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A186890CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Central California Faculty Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients

Locations

1247 E Alluvial Ave
Ste 101
Fresno, CA 93720
Phone (559) 431-6226

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

255 N Herwaldt Dr
Fresno, CA 93701
Phone (559) 459-7300

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

Interoperability endpoints

  • Direct secure messaging: kate.kiely.1@31788.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1083061253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 E ALLUVIAL AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202686",
            "telephone_number": "559-431-6226",
            "fax_number": "559-440-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELY",
        "first_name": "KATE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A186890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "KIELY",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.