Individual provider Active NPI

Jon Gregory McKellar, MD

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1275521916
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD11585 Issued in OR
Practice address
2218 Shallock Ave
Klamath Falls, OR 97601-4290
Phone
(541) 883-8134
Fax
(541) 883-1510
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD11585 OR Primary

Addresses

Primary practice location

2218 Shallock Ave
Klamath Falls, OR 97601-4290

Mailing address

2218 Shallock Ave
Klamath Falls, OR 97601-4290
Phone (541) 882-3818

Other identifiers 1

IdentifierTypeStateIssuer
1245228980OtherORNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080421000316 OR Practitioner - Family Practice 1254227580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cofas IncGroup PAC ID 1456360114, 6 clinicians

Practice addresses (Care Compare)

2218 Shallock Ave
Klamath Falls, OR 97601-4290
Phone (541) 882-3818

Hospital & facility affiliations

  • Sky Lakes Home Health Home health agency, Klamath Falls, OR, CCN 387075
  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Merit-based Incentive Payment System (MIPS)

Final score
90.84 of 100Reported as individual
Quality
88.85
Promoting interoperability
87
Improvement activities
40
Cost
91.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD11585ORMDFamily Medicine Physician
11585ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cofas Inc Family Medicine CurrentSince Apr 1, 2017 Accepting new patients
Central Oregon Dermatology, PC Past Accepting new patients

Locations

2218 Shallock Ave
Klamath Falls, OR 97601
Phone (541) 882-3818

Interoperability endpoints

  • Direct secure messaging: jon.mckellar.1@25961.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIAFAA
  • FHIR API: https://api.platform.athenahealth.com/25961/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1275521916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 SHALLOCK AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014290",
            "telephone_number": "541-882-3818",
            "fax_number": "541-882-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 SHALLOCK AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014290",
            "telephone_number": "541-883-8134",
            "fax_number": "541-883-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELLAR",
        "first_name": "JON",
        "middle_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD11585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245228980",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.