Individual provider Active NPI

Patricia Anne Kelly, MD

  • Cardiovascular Disease Physician
  • Missoula, MT
National Provider Identifier
1831149269
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
11020 Issued in MT
Practice address
2419 Mullan Rd Ste a
Missoula, MT 59808-1856
Phone
(406) 541-1400
Fax
(406) 514-1401
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 11020 MT Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 11020 MT

Addresses

Primary practice location

2419 Mullan Rd Ste a
Missoula, MT 59808-1856

Mailing address

PO Box 6011
Missoula, MT 59806-6011
Phone (406) 541-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20060601000232 MT Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 3971582867 Reassigns benefits to 1 organization
Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2419 Mullan Rd
Suite a
Missoula, MT 59808-1856
Phone (406) 541-1400

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11020MTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newton B. Coutinho MD PLLC Single Specialty PastSince Apr 22, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: patricia.kellymd.p1@direct.missoulacardiology.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1831149269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6011",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598066011",
            "telephone_number": "406-541-1400",
            "fax_number": "406-541-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 MULLAN RD STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081856",
            "telephone_number": "406-541-1400",
            "fax_number": "406-514-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MT",
            "license": "11020",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MT",
            "license": "11020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.