Individual provider Active NPI

Sean F Kelley, MD

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1356308290
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
16228 Issued in OK
Practice address
4317 W Memorial Rd
Oklahoma City, OK 73134-1720
Phone
(405) 775-9350
Fax
(405) 775-9360
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16228 OK Primary

Addresses

Primary practice location

4317 W Memorial Rd
Oklahoma City, OK 73134-1720

Mailing address

PO Box 26706
Oklahoma City, OK 73126-0706
Phone (405) 775-9350

Other identifiers 2

IdentifierTypeStateIssuer
100090310BMedicaidOK
P00372726OtherOKRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20051230000011 OK Practitioner - Anesthesiology 0143242529 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Anesthesia, LLC Anesthesiology CurrentSince Aug 28, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 15, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 15, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

3029 W Main St
Jenks, OK 74037
Phone (918) 346-5002

920 Stanton L Young Blvd
Oklahoma City, OK 73104
Phone (405) 271-5251

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: skelley@direct.uspi.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1356308290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26706",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260706",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341720",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SEAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "16228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090310B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00372726",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.