Ellen Marie Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.005148RX Issued in OH

Practice address

3373 Commerce Pkwy Ste 2
Wooster, OH 44691-7130

Phone

(330) 804-9712

Fax

(330) 804-9811

NPI assigned

May 25, 2017

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Wooster Orthopaedics and Sportsmedicine IncGroup PAC ID 6204733355, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wooster Community Hospital Hospital, Wooster, OH, CCN 360036
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

Merit-based Incentive Payment System (MIPS)

Final score

85.09 of 100Reported as group

Quality

86.75

Promoting interoperability

88

Improvement activities

40

Cost

73.56

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekelly@wosmc.medentdirect.com
• Direct secure messaging: ekelly130332@direct.metrohealth.org

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.

• Bloomington Medical Services LLC

  • Internal Medicine Physician
  • Wooster, OH
  • NPI 1528246683
  Medicare reassignment Care Compare group NPD
• Wooster Orthopaedics & Sportsmedicine Inc

  • Multi-Specialty Clinic/Center
  • Wooster, OH
  • NPI 1699729137
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Lorain Specialty Care LLC

  • Surgery Physician
  • Lorain, OH
  • NPI 1972126381

  Physician Assistant

  Medicare reassignment NPD
• Mercy Health Physicians Lorain Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Vermilion, OH
  • NPI 1255063145
  NPD
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• City of Wooster

  dba Wooster Community Hospital

  • General Acute Care Hospital
  • Wooster, OH
  • NPI 1437156247
  Care Compare affiliation
• Orrville Hospital Foundation

  dba Aultman Orrville Hospital

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1558899237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3373 COMMERCE PKWY STE 2",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917130",
            "telephone_number": "330-804-9712",
            "fax_number": "330-804-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3373 COMMERCE PKWY STE 2",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917130",
            "telephone_number": "330-804-9712",
            "fax_number": "330-804-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005148RX",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Keith, QMHS-B
• Alexis N Kelbley
• Keller Counseling & Consulting LLC (Keller Counseling & Consulting)
• Deborah M Keller
• Jill Nicole Keller, MSSA, LSW
• Gail Lynne Kelly
• K. Michelle Kelly, LSW, LPCC
• Lisa M. Kelly, MSW, LSW
• Michaela Kelly
• Martyne C Kempel, LISW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.