Derek Joseph Kelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036063365 Issued in IL

Practice address

800 Austin St Ste 157
Evanston, IL 60202-3452

Phone

(773) 293-3510

Fax

(773) 293-3514

NPI assigned

Mar 13, 2007

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Family Practice

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Northbrook, IL, CCN 147001
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

Merit-based Incentive Payment System (MIPS)

Final score

28.57 of 100Reported as individual

Quality

15

Improvement activities

0

Cost

75.25

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HAGGCA/Endpoint/HAGGCA

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.

• Sauganash Health Associates

  • Family Medicine Physician
  • Evanston, IL
  • NPI 1487843496
  Medicare reassignment NPD Authorized official

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

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Residential Home Health Illinois, LLC

  dba Residential Home Health

  • Home Health Agency
  • Northbrook, IL
  • NPI 1114673787
  Care Compare affiliation
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation
• Swedish Covenant Health

  dba Endeavor Health Swedish Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1407989106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 157",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023452",
            "telephone_number": "773-283-3510",
            "fax_number": "773-293-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 157",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023452",
            "telephone_number": "773-293-3510",
            "fax_number": "773-293-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEREK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036063365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0031600421",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Martin Lester Kellner, MD
• Kelly K. Schilder, LTD.
• Allison Kelly, OTR
• Amy B Kelly, MA
• Ashley E. Kelly, APN-CNP
• James Francis Kelly, DO
• Karen M. Kelly, PHARM.D.
• Jesse Kelso
• Elizabeth M Kelzer, PA-C
• Alexander Kemel, M.D.

• Family Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.