Individual provider Active NPI

Katharine Elizabeth Hays Kelly, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1851897573
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
81679-20 Issued in WI
Practice address
8320 W Bluemound Rd Ste 125
Milwaukee, WI 53213-3367
Phone
(414) 302-3800
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 81679-20 WI Primary

Addresses

Primary practice location

8320 W Bluemound Rd Ste 125
Milwaukee, WI 53213-3367

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100230464MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kkelly183960@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20230404000203 WI Practitioner - Family Practice 0244585321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

8320 W Bluemound Rd
Wauwatosa, WI 53213-3367
Phone (414) 302-3800

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81679-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Metro, Inc. Family Medicine CurrentSince Apr 8, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 8, 2023 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Apr 8, 2023 Accepting new patients

Locations

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8320 W Bluemound Rd
Wauwatosa, WI 53213
Phone (414) 302-3800

8320 W Bluemound Rd
Ste 125
Wauwatosa, WI 53213
Phone (414) 302-3800

Interoperability endpoints

  • Direct secure messaging: kkelly183960@direct.myadvocateaurora.org

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 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1851897573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 W BLUEMOUND RD STE 125",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532133367",
            "telephone_number": "414-302-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHARINE",
        "middle_name": "ELIZABETH HAYS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81679-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230464",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8320 W Bluemound Rd Ste 125",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532133367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkelly183960@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8320 W Bluemound Rd Ste 125",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532133367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.