Individual provider Active NPI

Joseph Alexander Kelamis, M.D.

  • Plastic Surgery Physician
  • Fort Smith, AR
National Provider Identifier
1821263765
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
E-9012 Issued in AR
Practice address
2717 S 74TH St
Fort Smith, AR 72903-5100
Phone
(479) 573-3799
Fax
(479) 573-3860
NPI assigned
Apr 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X E-9012 AR Primary

Addresses

Primary practice location

2717 S 74TH St
Fort Smith, AR 72903-5100

Mailing address

2717 S 74TH St
Fort Smith, AR 72903-5100
Phone (479) 573-3799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20150805009071 AR Practitioner - Plastic and Reconstructive Surgery 1759530835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Oklahoma College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Grant PL
Suite a
Lowell, AR 72745-7103
Phone (479) 935-3227

Hospital & facility affiliations

  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-9012ARMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc Plastic Surgery CurrentSince Jul 9, 2019 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 9, 2019 Accepting new patients
Kelamis Plastic Surgery, PLLC Plastic Surgery CurrentSince Feb 16, 2021 Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

101 Grant Pl
Ste A
Lowell, AR 72745
Phone (479) 275-3520

Interoperability endpoints

  • Direct secure messaging: jkelamis709796@directb.mercy.net
  • Direct secure messaging: jkelamis23200@washingtonregional.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1821263765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 S 74TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035100",
            "telephone_number": "479-573-3799",
            "fax_number": "479-573-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 S 74TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035100",
            "telephone_number": "479-573-3799",
            "fax_number": "479-573-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELAMIS",
        "first_name": "JOSEPH",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E-9012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.