Jacqueline R Kelly, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

33527 Issued in NE

Practice address

4101 Tiger Lily Rd Ste 100
Lincoln, NE 68516-5587

Phone

(402) 420-7000

Fax

(402) 420-6969

NPI assigned

Apr 4, 2014

Last updated

Mar 16, 2024By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Radiation Oncology

Education

Boston University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bryan Medical CenterGroup PAC ID 4284628652, 50 clinicians

Cancer Partners of Nebraska PCGroup PAC ID 9436148426, 30 clinicians

CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: admin@sncc.oncoemrdirect.com
• Direct secure messaging: jkelly192011@direct.ynhh.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.

• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370
  Medicare reassignment Care Compare group NPD
• Cancer Partners of Nebraska PC

  • Hematology & Oncology Physician
  • Lincoln, NE
  • NPI 1437111408
  Medicare reassignment Care Compare group NPD
• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065

  Radiation Oncology

  Medicare reassignment Care Compare group NPD
• Bryan Medical Center

  • Counseling Psychologist
  • Lincoln, NE
  • NPI 1497809966
  NPD
• Bryan Medical Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lincoln, NE
  • NPI 1629157789
  NPD
• Cancer Partners of Nebraska PC

  dba Cancer Partners of Nebraska at KCC

  • Hematology & Oncology Physician
  • Kearney, NE
  • NPI 1649151531

  Radiation Oncology

  NPD
• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  NPD (past)
• The Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437184652
  NPD (past)

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  dba Bryan Medical Center Laboratory

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Saint Elizabeth Regional Medical Center

  dba CHI Health St. Elizabeth

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738
  Care Compare affiliation

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1730507971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 N Kansas Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689014470",
            "country_code": "US",
            "telephone_number": "402-460-5899",
            "fax_number": "402-460-5898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NE",
            "license": "33527",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": "56098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@sncc.oncoemrdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4101 Tiger Lily Rd Ste 100",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685165587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Kellough
• Stacy Kellum, FNP-C
• Kelly & Associates Therapeutic Services LLC
• Allison Kelly
• Eric Kelly
• Julia Kelly
• Kayla Kelly
• Kendall Kelly, PA-C
• Lauren A Kelly, NP
• Lorin C Kelly, MA

• Radiation Oncology Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Radiation Oncology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2024; 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.