NPIMap

Individual provider Active NPI

Kevin M Kelly, MD

  • Neurology Physician
  • Pittsburgh, PA
National Provider Identifier
1356342109
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD057072L Issued in PA
Practice address
420 E North Ave Ste 206
Pittsburgh, PA 15212-4746
Phone
(412) 359-8850
Fax
(412) 359-8878
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD057072L PA Primary

Addresses

Primary practice location

420 E North Ave Ste 206
Pittsburgh, PA 15212-4746

Mailing address

420 E North Ave Ste 206
Pittsburgh, PA 15212-4746
Phone (412) 359-8850

Other identifiers 3

IdentifierTypeStateIssuer
0216325000MedicaidWV
2241256MedicaidOH
001549291MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkelly10999@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100305000674 PA Practitioner - Neurology 0840335568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Pittsburgh School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Neurophysiological Services LLCGroup PAC ID 4880772276, 3 clinicians

Practice addresses (Care Compare)

5001 Baum Blvd
Suite 530
Pittsburgh, PA 15213-1854
Phone (412) 681-9990

Hospital & facility affiliations

  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Ahn Wexford Hospital Hospital, Wexford, PA, CCN 390334
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD057072LPAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warren General Hospital CurrentSince Sep 1, 2018 Accepting new patients
Warren General Hospital CurrentSince Sep 1, 2018 Accepting new patients
Allegheny Clinic Current Accepting new patients
Clinical Neurophysiological Services, LLC CurrentSince Oct 3, 2025 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

5001 Baum Blvd
Ste 530
Pittsburgh, PA 15213
Phone (412) 681-9990

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: kkelly10999@direct.ahn.org

Organizations & group practices 5

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 6

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1356342109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E NORTH AVE STE 206",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124746",
            "telephone_number": "412-359-8850",
            "fax_number": "412-359-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E NORTH AVE STE 206",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124746",
            "telephone_number": "412-359-8850",
            "fax_number": "412-359-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD057072L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0216325000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241256",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001549291",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkelly10999@direct.ahn.org",
            "affiliation": "N",
            "address_1": "420 E North Ave Ste 206",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.