Michael Brian Kelly, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A121242 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 723-4000

NPI assigned

May 5, 2008

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkelly98219@santaclaravalley.direct-ci.net

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.

• County of Santa Clara

  dba SCVMC Physician Services

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  Medicare reassignment NPD
• County of Santa Clara

  dba Valley Health Center Alexian

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  dba Josefina Narvaez Mental Health Center MH Aoa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• County of Santa Clara

  dba Valley Health Center Lundy

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  dba Valley Health Center at East Valley

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1326033929
  NPD
• County of Santa Clara

  dba SCVMC Outpatient Pharmacy

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1881860260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A121242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Worasak Keeyapaj, MD
• Jennifer Keller, PHD
• Kathy Ann Keller, MD
• Lucy Kelliher
• Emily Katherine Kelly, AGACNP-BC
• Michael Patrick Kelly, MD
• Tara M Kelly, NP
• Timothy Dwyer Kelly, MD, MPH
• Victoria Marie Kelly, M.D.
• Ariella S. Kelman, MD

• Psychiatry Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.