Individual provider Active NPI

Nathan Ross Kelsey, M.D.

  • Diagnostic Radiology Physician
  • Twin Falls, ID
National Provider Identifier
1184943789
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M-14787 Issued in ID
Practice address
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone
(208) 814-1500
NPI assigned
May 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101250278 VA
Diagnostic Radiology Physician 2085R0202X M-14787 ID Primary

Addresses

Primary practice location

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

60MDG/SGQX
101 Bodin Cir
Travis AFB, CA 94535-1800
Phone (707) 423-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 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
I20210415000378 CA Practitioner - Diagnostic Radiology 1052640265 Reassigns benefits to 1 organization
I20220805001400 ID Practitioner - Diagnostic Radiology 1052640265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-1000

Hospital & facility affiliations

  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Jerome Hospital, Jerome, ID, CCN 131310
  • St Luke'S McCall Hospital, McCall, ID, CCN 131312
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Clinic LLC CurrentSince Apr 22, 2022 Accepting new patients
Radiology Physicians Inc Diagnostic Radiology CurrentSince Dec 24, 2020 Accepting new patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations (25 of 33)

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

1244 Meadow Bridge Dr
Beavercreek, OH 45434
Phone (937) 222-3118

2400 Lakeview Dr
Ste 100
Beavercreek, OH 45431
Phone (937) 429-4369

2300 Miami Valley Dr
Ste 150
Centerville, OH 45459
Phone (937) 280-8366

2400 Miami Valley Dr
Ste 210
Centerville, OH 45459

1222 S Patterson Blvd
Ste 360
Dayton, OH 45402
Phone (937) 496-2620

2300 Miami Valley Dr
Ste 350
Dayton, OH 45459
Phone (937) 424-2469

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

1530 Needmore Rd
Ste 301
Dayton, OH 45414
Phone (937) 938-9960

1520 S Main St
Dayton, OH 45409
Phone (937) 223-1279

9000 N Main St
Ste G-36
Englewood, OH 45415
Phone (937) 832-1093

9000 N Main St
Ste 333
Englewood, OH 45415
Phone (937) 832-8400

9000 N Main St
Ste 100
Englewood, OH 45415

9000 N Main St
Ste G
Englewood, OH 45415

742 Sweitzer St
Ste 3
Greenville, OH 45331
Phone (937) 459-5941

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

3120 Governors Place Blvd
Kettering, OH 45409
Phone (937) 208-6066

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

4214 Grand Ave
Middletown, OH 45044
Phone (513) 727-8860

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

501 Atrium Dr
Middletown, OH 45005
Phone (937) 245-6320

35 Overbrook Dr
Ste 100
Monroe, OH 45050
Phone (513) 539-7356

280 Looney Rd
Piqua, OH 45356
Phone (937) 440-4000

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 6

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1184943789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 POLE LINE RD W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015810",
            "telephone_number": "208-814-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60MDG/SGQX",
            "address_2": "101 Bodin Cir",
            "address_purpose": "LOCATION",
            "city": "Travis AFB",
            "state": "CA",
            "postal_code": "945351800",
            "country_code": "US",
            "telephone_number": "707-423-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "NATHAN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101250278",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-14787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.