NPIMap

Individual provider Active NPI

Douglas A Kelly, MD

  • Radiation Oncology Physician
  • Eureka, CA
National Provider Identifier
1497716781
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C193918 Issued in CA
Practice address
2700 Dolbeer St
Eureka, CA 95501-4736
Phone
(707) 269-4229
Fax
(707) 269-3849
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 19729 OK
Radiation Oncology Physician 2085R0001X DR0062949 CO
Radiation Oncology Physician 2085R0001X C193918 CA Primary

Addresses

Primary practice location

2700 Dolbeer St
Eureka, CA 95501-4736

Mailing address

154 Apple Valley LN
Eureka, CA 95503-9546
Phone (918) 269-6936

Other identifiers 1

IdentifierTypeStateIssuer
9000175543MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AZ, CA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20131118001424 GA Practitioner - Radiation Oncology 0648318188 Reassigns benefits to 1 organization
I20180219001996 AZ Practitioner - Radiation Oncology 0648318188 Reassigns benefits to 2 organizations
I20240418003555 CA Practitioner - Radiation Oncology 0648318188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
McGill University, Faculty of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians
Eureka Radiation Oncology ConsultantsGroup PAC ID 7719365618, 3 clinicians

Practice addresses (Care Compare)

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3000

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 269-4229

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
  • Providence Redwood Memorial Hospital Hospital, Fortuna, CA, CCN 051318
  • Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

Merit-based Incentive Payment System (MIPS)

Final score
78.52 of 100Reported as group
Quality
66.08
Promoting interoperability
100
Improvement activities
40
Cost
58.3

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C193918CAMDRadiation Oncology Physician
DR0062949COMDRadiation Oncology Physician
19729OKMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Arizona LLC Radiation Oncology CurrentSince Feb 1, 2018 Accepting new patients
Eureka Radiation Oncology Consultants CurrentSince Apr 15, 2024 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Kingman Healthcare, Inc CurrentSince Aug 1, 2023 Accepting new patients
City of Hope Medical Group of Georgia LLC Radiation Oncology CurrentSince Nov 1, 2013 Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients
City of Hope Medical Group of Arizona LLC PastSince Oct 17, 2021 Accepting new patients
Muskogee RT Associates LLC Radiation Oncology Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2915 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 207-3000

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: douglas.kelly.p2@direct.ctca-clinic.nextgenshare.com
  • Direct secure messaging: kelly.douglas@st.direct.azkrmc.md
  • Direct secure messaging: dkelly145433@cityofhope.direct-ci.com

Organizations & group practices 8

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 8

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1497716781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 APPLE VALLEY LN",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955039546",
            "telephone_number": "918-269-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-269-4229",
            "fax_number": "707-269-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OK",
            "license": "19729",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "DR0062949",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C193918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000175543",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.