Individual provider Active NPI

Mark Joseph Kelly, MD

  • Urology Physician
  • Fort Myers, FL
National Provider Identifier
1093889263
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME157212 Issued in FL
Practice address
8925 Colonial Center Dr Ste 2001
Fort Myers, FL 33905-7813
Phone
(239) 396-8930
Fax
(239) 396-8932
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G55252 CA
Urology Physician 208800000X ME157212 FL Primary

Addresses

Primary practice location

8925 Colonial Center Dr Ste 2001
Fort Myers, FL 33905-7813

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 396-8930

Other identifiers 2

IdentifierTypeStateIssuer
1598827826OtherINCORPORATION NPI
120219800MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkelly679437@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC
Direct Messaging Address MAR24666@cerner.directbaptisthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100728001028 CA Practitioner - Urology 8628101599
I20231017003209 FL Practitioner - Urology 8628101599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albert Einstein College of Medicine of Yeshiva University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

8925 Colonial Ctr Dr
Suite 2001
Fort Myers, FL 33905-7813
Phone (239) 343-9567

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G55252CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Aug 15, 2025 Accepting new patients
Lee Health System Inc CurrentSince Aug 15, 2025 Accepting new patients
Peter M Loisides MD, Inc Urology Past Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8925 Colonial Center Dr
Ste 2001
Fort Myers, FL 33905
Phone (239) 343-9567

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mar24666@cerner.directbaptisthealth.com
  • FHIR API: https://api.platform.athenahealth.com/16378/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mkelly679437@direct.leememorial.org

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 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1093889263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-396-8930",
            "fax_number": "239-396-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 COLONIAL CENTER DR STE 2001",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057813",
            "telephone_number": "239-396-8930",
            "fax_number": "239-396-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G55252",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME157212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INCORPORATION NPI",
            "identifier": "1598827826",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120219800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkelly679437@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MAR24666@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "8900 N Kendall Dr",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331762118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.