Kaidden Kelly, DMSC, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD-785 Issued in HI

Practice address

75-184 Hualalai Rd Ste 302
Kailua Kona, HI 96740-1719

Phone

(808) 329-0111

Fax

(808) 365-5811

NPI assigned

Oct 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Workstar Occupational Health Systems IncGroup PAC ID 8729978176, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kaidden.kelly@20467783892996.direct.elationemr.com
• Direct secure messaging: kaidden.kelly@490562416214020.direct.elationemr.com

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.

• Workstar Occupational Health Systems Inc

  • Occupational Medicine Physician
  • Kapolei, HI
  • NPI 1619989597
  Medicare reassignment Care Compare group
• MF Med Inc

  • Pain Medicine (Anesthesiology) Physician
  • Kailua Kona, HI
  • NPI 1407109085
  Medicare reassignment

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1083124135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-184 HUALALAI RD STE 302",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401719",
            "telephone_number": "808-329-0111",
            "fax_number": "808-365-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-184 HUALALAI RD STE 302",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401719",
            "telephone_number": "808-329-0111",
            "fax_number": "808-365-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KAIDDEN",
        "name_prefix": "Dr.",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaidden.kelly@20467783892996.direct.elationemr.com",
            "affiliation": "N",
            "address_1": "75-184 Hualalai Rd Ste 302",
            "city": "Kailua Kona",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967401719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.