Individual provider Active NPI

Ronan J Kelly, MD

  • Medical Oncology Physician
  • Dallas, TX
National Provider Identifier
1477846715
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
R8922 Issued in TX
Practice address
3410 Worth St Ste 400
Dallas, TX 75246-2092
Phone
(214) 370-1000
Fax
(214) 370-1986
NPI assigned
May 19, 2011
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R8922 TX
Medical Oncology Physician 207RX0202X R8922 TX Primary
Medical Oncology Physician 207RX0202X D72295 MD

Addresses

Primary practice location

3410 Worth St Ste 400
Dallas, TX 75246-2092

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 2

IdentifierTypeStateIssuer
392921801MedicaidTX
048473300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110920000355 MD Practitioner - Medical Oncology 1850562042 Reassigns benefits to 1 organization
I20190123001282 TX Practitioner - Medical OncologyPractitioner - Internal Medicine 1850562042 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Medical Oncology CurrentSince Jan 1, 2019 Accepting new patients
Johns Hopkins University CurrentSince Aug 7, 2011 Accepting new patients
Texas Oncology PA Medical Oncology Current Accepting new patients
Johns Hopkins University Medical Oncology CurrentSince Aug 7, 2011 Accepting new patients
Texas Oncology PA Medical Oncology CurrentSince Jan 1, 2019 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

600 N Wolfe St
Baltimore, MD 21287

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

3410 Worth St
Ste 400
Dallas, TX 75246
Phone (214) 370-1000

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3705 W 15th St
Plano, TX 75075
Phone (972) 867-3577

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1477846715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462092",
            "telephone_number": "214-370-1000",
            "fax_number": "214-370-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RONAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R8922",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "R8922",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MD",
            "license": "D72295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "392921801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048473300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.