Timothy Kelley, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

G78999 Issued in CA

Practice address

520 Superior Ave Ste 315
Newport Beach, CA 92663-3667

Phone

(949) 645-3223

Fax

(949) 645-3222

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Otolaryngology

Education

Wake Forest University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: timothy.kelley.p82@direct.nautilus.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: tkelley214288@westdirect.optum.com

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.

• Timothy F. Kelley, M.D., Inc.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1609948843
  Medicare reassignment NPD Authorized official
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1871528802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2975",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945855975",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 315",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633667",
            "telephone_number": "949-645-3223",
            "fax_number": "949-645-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "G78999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G789990",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.kelley.p82@direct.nautilus.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Timothy F. Kelley, M.D., Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "520 Superior Ave Ste 315",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926633667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitchell S Keil, PSYD
• Keith H Tam DDS Inc
• Shahrooz Sean Kelishadi, MD
• Dylan Joseph Kelley
• Selah Kelley
• Kelli a. Fox
• Kelli Junker DDS Inc
• Kelli Junker DDS Inc
• Sandra Kellum, M.D.
• Kelly Kazmierski, PHD, a Psychology Corporation

• Otolaryngology/Facial Plastic Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.