Sean Kelley, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A141999 Issued in CA

Practice address

200 Mission Blvd
Jackson, CA 95642-2564

Phone

(209) 223-7500

NPI assigned

Apr 7, 2014

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 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

Specialty

Diagnostic Radiology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael P Sherman MD PHD a Medical CorporationGroup PAC ID 9537113212, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skelley548734@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael P Sherman MD PHD, a Medical Corporation

  • Hematology & Oncology Physician
  • Walnut Creek, CA
  • NPI 1831201912
  Medicare reassignment Care Compare group NPD
• Mother Lode Diagnostic Imaging Inc

  • Diagnostic Radiology Physician
  • Jackson, CA
  • NPI 1053456061

  OR

  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Radiology

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1063487122
  Medicare reassignment NPD
• Sierra Hematology and Oncology Medical Centers

  • Hematology & Oncology Physician
  • Carmichael, CA
  • NPI 1992796759
  Medicare reassignment
• Open System MRI LLC.

  dba Open System Imaging

  • Diagnostic Radiology Physician
  • Chico, CA
  • NPI 1649718016
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Division of Vascular Surgery

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California San Francisco

  dba UCSF Medical Center Adult Chronic Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
  • NPI 1992818256
  NPD (past)

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1194144170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S LEXINGTON DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MISSION BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422564",
            "telephone_number": "209-223-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Medical Drive Slc Ut",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-581-7606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "513 Parnassus Ave Ste S-261",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432205",
            "country_code": "US",
            "telephone_number": "415-476-1575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A141999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K&B Pichette Enterprises, Inc. (Interim Healthcare of Amador, Calaveras and Tuolumne Counties)
• Rebecca Kaneshiro-Pacheco
• Karen Pantazis MD
• Tanya Karr, CMT
• Puneet Kaur, M.D.
• Gloria Lee Kent, RN,CNP
• Darrel Keith Kerr, MD
• Cassandra Lee King, FNP-BC
• Craig Allen Kinzer, DDS
• Johnna Kathleen Kladt

• Diagnostic Radiology Physician in Jackson, CA
• Providers in Jackson, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.