Individual provider Active NPI

Michael Patrick Kelly, MD

  • Orthopaedic Surgery Physician
  • Stanford, CA
National Provider Identifier
1508997420
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A100116 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 2010008619 MO
Orthopaedic Surgery Physician 207X00000X A100116 CA Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X A100116 CA

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other practice location 2

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 966-6789

Other identifiers 1

IdentifierTypeStateIssuer
205620107MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20211014001328 CA Practitioner - Orthopedic Surgery 9234308537 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Massachusetts Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rady Children'S Hospital San DiegoGroup PAC ID 3971677493, 164 clinicians
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

2125 Citracado Pkwy
Escondido, CA 92029-4159
Phone (760) 294-9260

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 576-1700

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100116CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 23, 2023 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Oct 1, 2021 Accepting new patients
Regents of the University of California Orthopaedic Surgery CurrentSince Jan 23, 2023 Accepting new patients
Stanford Health Care CurrentSince Feb 6, 2026 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Oct 1, 2021 Accepting new patients
Stanford Health Care CurrentSince Feb 6, 2026 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Feb 6, 2026 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Sep 12, 2021 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2125 Citracado Pkwy
Ste 100
Escondido, CA 92029
Phone (760) 739-1543

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

25170 Hancock Ave
Fl 1
Murrieta, CA 92562

3605 Vista Way
Ste 172
Oceanside, CA 92056
Phone (760) 547-1000

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

3030 Childrens Way
San Diego, CA 92123
Phone (858) 966-4003

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 11

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1508997420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2010008619",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A100116",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A100116",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205620107",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Ste 6A/6B/12A",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.