Sidney A Kelt Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

H1601 Issued in TX

Practice address

3500 Oaklawn Ave
Ste 300
Dallas, TX 75219-4349

Phone

(972) 709-1961

NPI assigned

May 10, 2006

Last updated

Dec 19, 2023By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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, Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sidney a. Kelt Jr., M.D., P.a.

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1316214364
  Authorized official Same address or phone
• Hamilton-Lucas Physicians PA

  • Psychiatry Physician
  • Desoto, TX
  • NPI 1215156062
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1902855430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OAKLAWN AVE",
            "address_2": "STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194349",
            "telephone_number": "972-709-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OAKLAWN AVE",
            "address_2": "STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194349",
            "telephone_number": "972-709-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELT",
        "first_name": "SIDNEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H1601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "752484883",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "00A32X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113854702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Denise Kelly, PHARMD
• Stephanie Lynn Kelly, M.A., BCBA
• Vashonia Kelly, NP
• David Kelm
• Andrew Patrick Kelsey, D.D.S.
• Kaitlyn Kelton
• Philip Llewellyn Kelton Jr., M.D.
• Stephanie Kelton, APN
• Thomas Fowler Kelton, MD
• Kem Wellness, LLC

• Psychiatry Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.