Thomas Kiely, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29279 Issued in CA

Practice address

100 Shoreline Hwy
BLDG B, Suite 100
Mill Valley, CA 94941

Phone

(415) 877-4408

NPI assigned

Jan 2, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194882886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 HURLINGHAM AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021030",
            "telephone_number": "650-455-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHORELINE HWY",
            "address_2": "BLDG B, SUITE 100",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-877-4408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Nelson Rising Ln Ste 190",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941430003",
            "country_code": "US",
            "telephone_number": "415-353-2057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 El Camino Real",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "94010",
            "country_code": "US",
            "telephone_number": "650-652-4884",
            "fax_number": "650-697-3931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIELY",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Norah Kennard
• Morgan Rebecca Kennedy, PH.D.
• Uta Barbara Kerl, M.D.
• Nivedita Keshav, MD
• Jennifer Kichinko
• Lynn Killips, PSYD, MS, MA
• Kim Lori Hoppin
• Jane Jihyeon Kim, PHARM. D.
• Mariam Jane King, PSY,.D.
• Michelle Kipper, LMFT

• Clinical Psychologist in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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; Opt Out Affidavits.
• 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.