Individual provider Active NPI

Ma Ley Celeste Galanida Kelly, M.D.

  • Hospitalist Physician
  • Brunswick, GA
National Provider Identifier
1487917159
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
074322 Issued in GA
Practice address
2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone
(912) 466-7188
Fax
(912) 466-7185
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 074322 GA
Hospitalist Physician 208M00000X 074322 GA Primary

Addresses

Primary practice location

2415 Parkwood Dr
Brunswick, GA 31520-4722

Mailing address

PO Box 1213
Brunswick, GA 31521-1213
Phone (912) 466-7188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831001885 GA Practitioner - HospitalistPractitioner - Family Practice 2365683026 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peter Wrobel MD PCGroup PAC ID 0345390795, 3 clinicians
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

1720 Old Reynolds St
Waycross, GA 31501-1036
Phone 9122831359185

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.36 of 100Reported as group
Quality
46.72
Promoting interoperability
99
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
074322GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients

Locations

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

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 2

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1487917159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1213",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315211213",
            "telephone_number": "912-466-7188",
            "fax_number": "912-466-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204722",
            "telephone_number": "912-466-7188",
            "fax_number": "912-466-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MA LEY",
        "middle_name": "CELESTE GALANIDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "074322",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "074322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.