Benjamin F Kelley, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

A155759 Issued in CA

Practice address

10820 N Torrey Pines Rd
La Jolla, CA 92037-1036

Phone

(858) 554-8646

Fax

(858) 554-6271

NPI assigned

Dec 11, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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

Specialty

Dermatology

Education

Rush Medical College of Rush University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Berman Skin Institute Medical Group IncGroup PAC ID 0042407215, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkelley79488@scrippshlth.medalliesdirect.net

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.

• Berman Skin Institute Medical Group Inc

  • Dermatology Physician
  • Los Altos, CA
  • NPI 1528175528
  Medicare reassignment Care Compare group NPD
• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  Dermatology

  Medicare reassignment Care Compare group NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  NPD (past)
• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499
  NPD (past)
• Mayo Clinic Health System-Lake City

  • Critical Access Hospital
  • Lake City, MN
  • NPI 1538113022
  NPD (past)

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

• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  Care Compare affiliation

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1659702942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-8646",
            "fax_number": "858-554-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371036",
            "telephone_number": "858-554-8646",
            "fax_number": "858-554-6271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Santa Fe Dr Ste 207",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245140",
            "country_code": "US",
            "telephone_number": "760-633-7234",
            "fax_number": "760-436-9838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "BENJAMIN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-11",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A155759",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "107728",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A155759",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MN",
            "license": "58373",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A155759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cortney Keckley, FNP-BC
• Daniel T. Keefe, M.D.
• Donna Lynn Keefe, L.AC.
• Hollie Keene
• Kelli Anne Keene
• Jessica Kelley, NP
• Amorah Kelly, L.AC.
• Cerra Michaela Kelly, ND
• Quyen Nguyen Kelly, MD
• Tamsin Lisa Kelly, MD

• MOHS-Micrographic Surgery Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• MOHS-Micrographic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.