NPIMap

Individual provider Active NPI

Alan J Kelly, MD

  • Internal Medicine Physician
  • Spokane Valley, WA
National Provider Identifier
1306834833
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BC60304772 Issued in WA
Practice address
1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1557
Phone
(509) 924-1950
Fax
(509) 921-0017
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BC60304772 WA Primary

Addresses

Primary practice location

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1557

Mailing address

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1557
Phone (509) 924-1950

Other identifiers 1

IdentifierTypeStateIssuer
151073MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000088 WA Practitioner - Internal Medicine 6901838580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nevada School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

300 E 5TH Ave
Spokane, WA 99202-1334

311 S L St
Tacoma, WA 98405-3720

400 E 5TH Ave
Spokane, WA 99202-1334
Phone (509) 838-2531

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Spokane Valley, WA, CCN 507021
  • Assured Home Health Home health agency, Spokane, WA, CCN 507089
  • Eden Home Health Home health agency, Spokane Valley, WA, CCN 507130
  • Providence at Home With Compassus Home Health, Inwa Home health agency, Spokane Valley, WA, CCN 507019
  • Sunshine Home Health Care Home health agency, Spokane, WA, CCN 507119
  • Horizon Hospice Hospice, Spokane, WA, CCN 501535
  • Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119
  • Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Nov 26, 2018 Accepting new patients
Multicare Health System CurrentSince Nov 26, 2018 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: akelly389512@direct.multicare.org

Organizations & group practices 4

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 9

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1306834833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161557",
            "telephone_number": "509-924-1950",
            "fax_number": "509-921-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161557",
            "telephone_number": "509-924-1950",
            "fax_number": "509-921-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ALAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "BC60304772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151073",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.