Individual provider Active NPI

Matthew Kelly

  • Emergency Medicine Physician
  • Birmingham, AL
National Provider Identifier
1265460109
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
29159 Issued in AL
Practice address
1717 6TH Ave S
Birmingham, AL 35233-1801
Phone
(800) 822-8816
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 29159 AL Primary

Addresses

Primary practice location

1717 6TH Ave S
Birmingham, AL 35233-1801

Mailing address

1717 6TH Ave S
Birmingham, AL 35233-1801

Other practice location 1

619 19th St S
Birmingham, AL 35233-1900
Phone (205) 975-7387

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpkelly@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20081120000815 AL Practitioner - Emergency Medicine 3072507508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Birmingham, AL, CCN 017054
  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue68
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29159ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Undersea and Hyperbaric Medicine CurrentSince May 1, 2015 Accepting new patients
University of Alabama at Birmingham Past Accepting new patients
Van Meter MD & Associates Past Accepting new patients
University of Alabama at Birmingham Emergency Medicine Past Accepting new patients
Southern Solano Emergency Medical Group, Inc Emergency Medicine Past Accepting new patients
Keith Van Meter & Associates Past Accepting new patients
Coosa River Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

995 9th Ave SW
Bessemer, AL 35022
Phone (205) 481-7155

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1806 6th Ave S
Birmingham, AL 35233
Phone (205) 939-9587

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

619 19th St S
Birmingham, AL 35249

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3620 Hamilton Walk
Fl 1
Philadelphia, PA 19104
Phone (215) 898-9095

Organizations & group practices 10

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 3

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1265460109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801",
            "telephone_number": "800-822-8816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-975-7387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "29159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpkelly@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "619 19th St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352331900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.