Molly Mae Kelly, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036130382 Issued in IL

Practice address

2202 Harlem Rd Ste 200
Loves Park, IL 61111-2754

Phone

(815) 877-4848

Fax

(815) 636-6125

NPI assigned

Jun 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Molly Mae Myers Other name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Anesthesiology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Rockford Anesthesiologists Associated LLCGroup PAC ID 5597668004, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Rockford Anesthesiologists Associated, L.L.C.

  • Anesthesiology Physician
  • Loves Park, IL
  • NPI 1639128598
  Medicare reassignment Care Compare group
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Ottawa, IL
  • NPI 1306971080
  Medicare reassignment
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1154908929
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Rockford Anesthesiologists Associated, L.L.C.

  • Certified Registered Nurse Anesthetist
  • Loves Park, IL
  • NPI 1629090642
  NPD (past)

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

• Osf Healthcare System

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1114187705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD STE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-636-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD STE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-636-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MOLLY",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036130382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130382",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MYERS",
            "middle_name": "MAE",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Onyinyechi Chinyere Kalagbor, MD
• Mohammed Kaleemuddin, M.D.
• John E. Kallich, M.D.
• Katherine F. Stewart D.D.S, L.L.C
• Alix Kavran, LCPC
• Jarrod Steven Kerkhoff, DC
• Umm E Farwa Khan, MD
• John Kim
• Lenney G. Kizhakepunnur, M.D.
• Janelle Kloch, APN

• Anesthesiology Physician in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.