Patrick John Kelly, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34054 Issued in TX

Practice address

3066 E Commerce St
San Antonio, TX 78220-1013

Phone

(210) 233-7000

NPI assigned

Jun 13, 2018

Sex

Male

Sole proprietor

No

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Barrio Comprehensive Family Health Care Center, Inc.

  dba CommuniCare Health Centers

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1902883739
  Medicare reassignment NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1295601052
  NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  dba Communicare Health Centers

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1386882231
  NPD
• New Braunfels Modern Dentistry,PC

  dba New Braunfels Modern Dentistry

  • Dentist
  • New Braunfels, TX
  • NPI 1700332723
  NPD (past)
• Webster Street Dental PLLC

  dba Elevate Dental

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1710487780
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1730672833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazzmine Chiree Kelly
• Jennifer Kelly, SLP-CFY
• Joseph Francis Kelly, M.D.
• Laura Kelly, RN
• Melissa Anna Kelly, LPC, LCDC
• Robert James Kelly Jr., PHARM D
• Sean M Kelly
• Tamara Lynn Kelly, RN, MSN
• Theresa J. Kelly, OTR
• Timothy Michael Kelly, ATC

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.