Keith Stefon Kelly, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

D0054969 Issued in MD

Practice address

11701 Livingston Rd Ste 308
Fort Washington, MD 20744-5146

Phone

(301) 292-6140

Fax

(240) 559-0895

NPI assigned

Apr 3, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Obstetrics/Gynecology

Education

Howard University College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Keith S Kelly MD PC

  • Gynecology Physician
  • Hughesville, MD
  • NPI 1912183781

  DC

  Medicare reassignment Authorized official
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1770604043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 LIVINGSTON RD STE 308",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445146",
            "telephone_number": "301-632-6900",
            "fax_number": "301-632-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 LIVINGSTON RD STE 308",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445146",
            "telephone_number": "301-292-6140",
            "fax_number": "240-559-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KEITH",
        "middle_name": "STEFON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D0054969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156002600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kandydina, LLC
• Ruth M Kanthula, MD, MPH
• Scolastica Kirumba Kariithi
• Brenda Maureen Kavanaugh-Davis
• Corinne Mireille Kayem Guifo
• Reginald Desmond Key Jr.
• Kimberly Morris Keys, D.M.D.
• Rashid M Khan, MD
• Shaun Khosla, M.D.
• Samuel Kleiman, M.D.

• Gynecology Physician in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.