Individual provider Active NPI

Molly A Kelly, MD

  • Hospitalist Physician
  • Roanoke, IN
National Provider Identifier
1780112870
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01081728A Issued in IN
Practice address
10101 Ernst Rd Ste 1200
Roanoke, IN 46783-9711
Phone
(260) 234-5400
Fax
(260) 235-5410
NPI assigned
Jun 1, 2017
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01081728A IN
Family Medicine Physician 207Q00000X 01081728A IN
Hospitalist Physician 208M00000X 01081728A IN Primary

Addresses

Primary practice location

10101 Ernst Rd Ste 1200
Roanoke, IN 46783-9711

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

221 N Celia Ave
Muncie, IN 47303-4609
Phone (765) 747-3141

Other identifiers 4

IdentifierTypeStateIssuer
000001338628OtherINANTHEM PTAN
000001338637OtherINANTHEM PTAN
000001525751OtherINANTHEM PTAN
300007459MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20190822001414 IN Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Hospitalist 7719215268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01081728AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Physicians, Inc. Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Indiana University Health Fort Wayne Physicians, LLC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

7230 Engle Rd
Ste 100
Fort Wayne, IN 46804
Phone (317) 620-0232

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

500 W Votaw St
Portland, IN 47371
Phone (260) 726-6515

10101 Ernst Rd
Ste 1200
Roanoke, IN 46783

Interoperability endpoints

  • Direct secure messaging: mkelly8@direct.iuhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1780112870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 ERNST RD STE 1200",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467839711",
            "telephone_number": "260-234-5400",
            "fax_number": "260-235-5410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 N Celia Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473034609",
            "country_code": "US",
            "telephone_number": "765-747-3141",
            "fax_number": "765-741-2977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MOLLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01081728A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01081728A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01081728A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001338628",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001338637",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001525751",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007459",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, IN

Sources for this page

Verify at the official NPI Registry.