Individual provider Active NPI

Megan Cathleen Kelly, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1093334112
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70389 Issued in AZ
Practice address
9015 N 3Rd St
Phoenix, AZ 85020-2444
Phone
(480) 882-4545
Fax
(602) 714-3755
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 70389 AZ Primary

Addresses

Primary practice location

9015 N 3Rd St
Phoenix, AZ 85020-2444

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Other identifiers 1

IdentifierTypeStateIssuer
135555MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230815001211 AZ Practitioner - Family Practice 9830512870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Outreach Access to HealthGroup PAC ID 3577743764, 107 clinicians

Practice addresses (Care Compare)

9015 N 3Rd St
Phoenix, AZ 85020-2444
Phone (480) 882-4545

Hospital & facility affiliations

  • Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health CurrentSince Sep 1, 2023 Accepting new patients
Neighborhood Outreach Access to Health Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

9015 N 3rd St
Phoenix, AZ 85020

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

20440 N 27th Ave
Phoenix, AZ 85027

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

16251 N Cave Creek Rd
Phoenix, AZ 85032

8705 E McDowell Rd
Scottsdale, AZ 85257

Interoperability endpoints

  • Direct secure messaging: mkelly671326@direct.ochin.org

Organizations & group practices 2

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 1

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1093334112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202444",
            "telephone_number": "480-882-4545",
            "fax_number": "602-714-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MEGAN",
        "middle_name": "CATHLEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "70389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135555",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.