Michael Joseph Kelly Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4618 Issued in OK

Practice address

6585 S Yale Ave Ste 720
Tulsa, OK 74136-8320

Phone

(918) 502-5930

Fax

(918) 502-5935

NPI assigned

Oct 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
• Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
• Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkelly248514@direct.saintfrancis.com
• Direct secure messaging: michael.kelly.3@4082.direct.athenahealth.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Physician Assistant

  NPD (past)

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

• Saint Francis Hospital Muskogee Inc

  • General Acute Care Hospital
  • Muskogee, OK
  • NPI 1386188837
  Care Compare affiliation
• Saint Francis Hospital South LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Vinita, OK
  • NPI 1467902460
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Psychiatric Hospital Unit
  • Vinita, OK
  • NPI 1578013579
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • General Acute Care Hospital
  • Vinita, OK
  • NPI 1700334232
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1740366111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6653",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 720",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368320",
            "telephone_number": "918-502-5930",
            "fax_number": "918-502-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4618",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "2567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kelly
• Connor McClain Kelly
• Dawn Kelly
• Hollis Creg Kelly
• Jasmine Kelly
• Patrick Kelly
• Rita Michele Kelly
• Shannon Kelly, AAPS
• Shelly Ann Kelly, ARNP
• Tayla Kelly, CBD

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.