Michaela J Clark-Kelley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1802 Issued in ME

Practice address

15 Enterprise Dr
Augusta, ME 04330-7997

Phone

(207) 621-8800

Fax

(207) 621-8801

NPI assigned

Nov 4, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelaclark-kelley@mgh.allscriptsdirect.net

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380

  ME

  Medicare reassignment Care Compare group NPD
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  Care Compare group NPD
• Mainegeneral Medical Center

  • Family Medicine Physician
  • Augusta, ME
  • NPI 1063716710
  Care Compare group
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1174858278
  Care Compare group
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1083949184
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Redington-Fairview General Hospital

  • Critical Access Hospital
  • Skowhegan, ME
  • NPI 1174549133

  Hospital

  Care Compare affiliation
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

University of New England, College of Osteo Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainegeneral Medical Center 554 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039
• Redington Fairview General Hospital Hospital, Skowhegan, ME, CCN 201314
• Northern Light Sebasticook Valley Hospital Hospital, Pittsfield, ME, CCN 201313

Procedures performed for Medicare patients

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1306837620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307997",
            "telephone_number": "207-621-8800",
            "fax_number": "207-621-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307997",
            "telephone_number": "207-621-8800",
            "fax_number": "207-621-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-KELLEY",
        "first_name": "MICHAELA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431974999",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gayle Lynn Chung, LMT
• Michael N Chupka, PHARMD
• Alfred Bernard Cichon, PHYSICIAN ASSISTANT
• City of Augusta
• City of Augusta Treasurer
• Christopher James Clark, DO
• John David Clark III, CADC
• Morgan Clark, NP
• Patricia Clark
• Wendy Claveau

• All providers in Augusta, ME
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.