Wayne David Kelly, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

036078457 Issued in IL

Practice address

1883 Hicks Rd
Suite a
Rolling Meadows, IL 60008-1254

Phone

(847) 359-9432

NPI assigned

Oct 10, 2006

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

Other identifiers 1

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

Neurology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: waynekelly@tpmasrs-il.direct.office.nextgen.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• TLC Pain Management & Sleep Restoration SC

  • Interventional Pain Medicine Physician
  • Rolling Meadows, IL
  • NPI 1003019779
  Medicare reassignment NPD Authorized official
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD (past)
• Joliet Pain Care Center

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Joliet, IL
  • NPI 1043322001
  NPD (past)
• Pain Care America

  • Physical Medicine & Rehabilitation Physician
  • Darien, IL
  • NPI 1912019977
  NPD (past)
• Sangamon County Pain Center

  • Chiropractor
  • Springfield, IL
  • NPI 1518172162
  NPD (past)
• Suburban Paincare Center P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Naperville, IL
  • NPI 1255443222
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518220800000",
    "number": "1164519005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 HICKS RD",
            "address_2": "SUITE A",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081254",
            "telephone_number": "847-359-9432",
            "fax_number": "888-687-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 HICKS RD",
            "address_2": "SUITE A",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081254",
            "telephone_number": "847-359-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WAYNE",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036078457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL LICENSE",
            "identifier": "036078457",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Kalamaras
• Jennifer Cohan Kalteux, M.S.
• Pavlo Kasiyan, DDS
• Katie Wagner Therapy PLLC
• Rachel Lillian Kautz, PHARMD
• Mark Allen Keresztesy, D.C.
• Kelly Ann Keyzer, DPT
• Basharath Mohammed Ali Khan, MD
• Saad Khan
• Bonnie Mija Kim, LCPC

• Interventional Pain Medicine Physician in Rolling Meadows, IL
• Providers in Rolling Meadows, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.