NPIMap

Individual provider Active NPI

Douglas Craig Kelly, MD

  • Urology Physician
  • Virginia Beach, VA
National Provider Identifier
1568605244
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101257567 Issued in VA
Practice address
225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone
(757) 457-5100
Fax
(757) 961-3696
NPI assigned
Apr 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 0101257567 VA Primary

Addresses

Primary practice location

225 Clearfield Ave
Virginia Beach, VA 23462-1815

Mailing address

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100

Other identifiers 1

IdentifierTypeStateIssuer
1568605244MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616001289 VA Practitioner - Urology 8426271735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of North Carolina at Chapel Hill School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of Virginia, PLLCGroup PAC ID 2062681679, 74 clinicians

Practice addresses (Care Compare)

229 Clearfield Ave
Suite 300
Virginia Beach, VA 23462-1815
Phone (757) 457-5177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.25 of 100Reported as group
Quality
57.23
Promoting interoperability
100
Improvement activities
40
Cost
73.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection60

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101257567VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Virginia, PLLC Urology CurrentSince Jul 1, 2015 Accepting new patients
Urology of Virginia, PLLC Urology CurrentSince Jul 1, 2015 Accepting new patients

Locations

225 Clearfield Ave
Virginia Beach, VA 23462
Phone (757) 452-3459

Interoperability endpoints

  • Direct secure messaging: dkelly1152593@direct.bsmhealth.org

Organizations & group practices 2

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": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1568605244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DOUGLAS",
        "middle_name": "CRAIG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-11",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101257567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568605244",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.