Kanwar Singh Kelley, M.D., J.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A123114 Issued in CA

Practice address

77 Moraga Way Ste G
Orinda, CA 94563

Phone

(925) 254-6710

NPI assigned

Apr 6, 2011

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Male

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

Other names 1

• Kanwarjit Singh Kelley Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Otolaryngology

Education

R Franklin University of Med & Sci/Chicago Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Joaquin Faculty Medical GroupGroup PAC ID 4082631395, 126 clinicians

County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Strawberry Creek Medical Group of California PCGroup PAC ID 5799015798, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

71.65

Improvement activities

40

Cost

57.96

Merit-based Incentive Payment System (MIPS)

Final score

53.98 of 100Reported as group

Quality

11.8

Promoting interoperability

74

Improvement activities

0

Cost

82.7

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Strawberry Creek Medical Group of California PC

  • General Practice Physician
  • Orinda, CA
  • NPI 1447806096

  Otolaryngology

  Medicare reassignment Care Compare group NPD Authorized official
• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment Care Compare group NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment Care Compare group NPD
• Sigma Ear Nose & Throat

  dba Sigma ENT

  • Otolaryngology Physician
  • Pinole, CA
  • NPI 1972268159
  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636

  Otolaryngology

  NPD
• Alta Bates Summit Medical Center

  dba Merritt Peralta Insititute

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1275605180
  NPD (past)

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

• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1336438670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MORAGA WAY STE G",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633019",
            "telephone_number": "925-254-6710",
            "fax_number": "925-254-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MORAGA WAY STE G",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "94563",
            "telephone_number": "925-254-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Estudillo Ave",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774908",
            "country_code": "US",
            "telephone_number": "510-483-3565",
            "fax_number": "510-483-3566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KANWAR",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D., J.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A123114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842637791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANWARJIT",
            "last_name": "KELLEY",
            "middle_name": "SINGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ernest A Kahl, D.D.S.
• Bryn Johanna Kahn, PSY.D.
• Paul M. Kasrovi, DDS,MS
• Brian Kimball Kay, MFT, LPCC
• Paula Keebler, NBC-HWC
• Judith D. Kellman, M.D.
• Linda Uin Soo Kim, MD
• Min-Jeong Kim, DDS
• Inger Kirschenbaum, PH.D, MFT
• Lisa B Kollin, COTA

• Otolaryngology Physician in Orinda, CA
• Providers in Orinda, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.