Individual provider Active NPI

Monica Maria Kelly, M.D.

  • Pediatrics Physician
  • Boys Town, NE
National Provider Identifier
1164873089
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
7740 Issued in NE
Practice address
14080 Boys Town Hospital Rd
Boys Town, NE 68010-7513
Phone
(531) 355-6900
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 7740 NE Primary

Addresses

Primary practice location

14080 Boys Town Hospital Rd
Boys Town, NE 68010-7513

Mailing address

14080 Boys Town Hospital Rd
Boys Town, NE 68010-7513
Phone (531) 355-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20190829000498 NE Practitioner - Pediatric Medicine 3971898040 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7740NEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients
ENT Services PC Past Accepting new patients
Father Flanagan's Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1164873089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14080 BOYS TOWN HOSPITAL RD",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107513",
            "telephone_number": "531-355-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14080 BOYS TOWN HOSPITAL RD",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107513",
            "telephone_number": "531-355-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MONICA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "7740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boys Town, NE

Sources for this page

Verify at the official NPI Registry.