Kyle Kelly, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.00763RX Issued in OH

Practice address

4350 Crocker Road
Ste 300
Westlake, OH 44145-6329

Phone

(440) 558-8005

Fax

(440) 835-4790

NPI assigned

Dec 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Dermatology and Skin Surgery Center, LLCGroup PAC ID 1052589777, 52 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.28 of 100Reported as group

Quality

78.38

Promoting interoperability

92

Improvement activities

40

Cost

79.23

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kkelly@apexskin.emadirect.md

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.

• Apex Dermatology and Skin Surgery Center, LLC

  • Dermatology Physician
  • Mayfield Heights, OH
  • NPI 1689973638
  Medicare reassignment Care Compare group
• Baldwin Wallace University

  • Student Health Clinic/Center
  • Berea, OH
  • NPI 1730157272
  NPD (past)
• Gary R Kutsikovich MD and Associates Inc

  • Neurology Physician
  • Mentor, OH
  • NPI 1841250420
  NPD (past)
• SCH Professional Corporation

  • Family Medicine Physician
  • Salem, OH
  • NPI 1619959822
  NPD (past)

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1457948804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 AUBURN DR.",
            "address_2": "STE. 350",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224327",
            "telephone_number": "440-646-1600",
            "fax_number": "440-646-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 CROCKER ROAD",
            "address_2": "STE 300",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456329",
            "telephone_number": "440-558-8005",
            "fax_number": "440-835-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-30",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.00763RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018527",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany J Kelly, MA, CDCA, LPCC, LCDC
• Carol Loreen Kelly, NP-C
• Evelyn Marie Kelly, BSW
• John Henry Kelly, D.D.S.
• Kate W Kelly, DDS
• Robert Kemmerer
• Zelalem Kenea
• Alayna Rei Kennedy
• Troy A Kennedy, OT
• Anna C Kennerknecht, AU.D., CCC-A

• Physician Assistant in Westlake, OH
• Providers in Westlake, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.