Kevin M. Kelly Jr.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A71711 Issued in CA

Practice address

5555 Grossmont Center Drive
La Mesa, CA 91942-3019

Phone

(619) 644-4401

NPI assigned

Jun 27, 2006

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

Other identifiers 2

Other names 1

• Dr. Kevin Michael Kelly Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Emergency Medicine

Education

University of California, Geffen School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Diego Emergency Physicians IncGroup PAC ID 1052771698, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Merit-based Incentive Payment System (MIPS)

Final score

94.74 of 100Reported as group

Quality

79.48

Improvement activities

40

Cost

87.88

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• San Diego Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1194429233
  Medicare reassignment Care Compare group NPD
• Alvarado Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1285811992
  Medicare reassignment NPD
• Emergency Services Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1699725069
  Medicare reassignment NPD
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)
• Pacific Emergency Providers, a Prof. Corp.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1497790539
  NPD (past)

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

• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1811924764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12170",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852170",
            "telephone_number": "877-818-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DRIVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-644-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A71711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A71711",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A717110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "KELLY",
            "middle_name": "MICHAEL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wilfred S. Kearse Jr., M.D.
• Meesun Keel-Hammer, PHARM.D.
• Kathleen Matthews Keenan
• Thomas Allen Keller, PH.D.
• Alexandra Kristine Kellogg, PA-C
• Tammy Boyette Kelly, PA-C
• Thomas B Kelly
• Kassandra Jeannette Kelton
• Stephan John Kempiak, M.D,PH.D
• Komal Kenkare, PMHNP-BC

• Emergency Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.