Kenneth J Kelly, M.D.

Primary specialty

Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X

License

MD7948 Issued in HI

Practice address

2000 Trident Way
San Diego, CA 92155-5599

Phone

(808) 474-9333

Fax

(619) 437-3197

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Emergency Medicine

Education

Michigan State University College of Human Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

Merit-based Incentive Payment System (MIPS)

Final score

67.07 of 100Reported as apm

Quality

85.4

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkelly87191@surescripts.sfmc.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.

• Saint Francis Medical Center

  • Anesthesiology Physician
  • Cape Girardeau, MO
  • NPI 1356304489
  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Jackson, MO
  • NPI 1932454956
  NPD
• Saint Francis Medical Center

  • Clinic/Center
  • Jackson, MO
  • NPI 1992502975
  NPD

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

• Saint Francis Medical Center

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1467412726
  Care Compare affiliation
• Saint Francis Medical Center

  • Internal Medicine Physician
  • Cape Girardeau, MO
  • NPI 1578513016

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730224908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 TRIDENT WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555599",
            "telephone_number": "808-474-9333",
            "fax_number": "619-437-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TRIDENT WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555599",
            "telephone_number": "808-474-9333",
            "fax_number": "619-437-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "HI",
            "license": "MD7948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Celeste Kelly
• Jessica Kelly, LVN
• John G Kelly, HIS
• Katherine Ann Kelly, MD
• Katrina L. Kelly, M.D.
• Kerri Zuba Kelly, LCSW
• Kyle Kelly
• Matthew Robert Kelly, M.D.
• Morgan Kelly
• Nancy Kelly, OTR

• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.