Ray Kelley, MD
Individual provider Active NPI Family Medicine Physician · Albuquerque, NM
NPI 1104455328 · NPPES record last updated Aug 6, 2026
Key facts
- NPI
- 1104455328
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2023-1365 (NM)
- Practice address
- 1 Sagebrush St SW
Albuquerque, NM 87105-3942 - Phone
- (505) 869-3200
- Fax
- (505) 869-4088
- NPI assigned
- Apr 8, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of California, San Francisco School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Pueblo of Isleta
Practice addresses (Care Compare)
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone (505) 869-4463
Hospital & facility affiliations
- Klarus Home Care, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240209002020 | NM | Practitioner - Family Practice | 2062838048 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2023-1365 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Isleta | Current |
Accepting new patients | |
| Pueblo of Isleta | Current |
Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients |
Locations
1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD2023-1365 | NM | Yes |
Addresses
Primary practice location
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Mailing address
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone (505) 869-3200
Other providers in Albuquerque, NM
- Gretchen Marie Kelley
- Isabella Kelley
- Jonathan Harper Kelley
- Matthew Brian Kelley
- Naomi Kelley
- Tania Kelley
- Kara Kellogg
- Riannah Kellogg
- Robert T Kellogg
- Allison Kelly
All providers in Albuquerque, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.