Individual provider Active NPI

Thomas Edgar Kelly, M.D.

  • Emergency Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1902888985
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
43448 Issued in AZ
Practice address
7645 E Windrose Dr
Scottsdale, AZ 85260-4829
Phone
(480) 231-0609
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43448 AZ Primary

Addresses

Primary practice location

7645 E Windrose Dr
Scottsdale, AZ 85260-4829

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Other practice location 1

5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tkelly1175710@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100921001277 AZ Practitioner - Emergency Medicine 7810013307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43448AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Nov 1, 2014 Accepting new patients
Mayo Clinic Arizona CurrentSince Feb 1, 2020 Accepting new patients
Mayo Clinic Arizona CurrentSince Feb 1, 2020 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients

Locations

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

13400 E Shea Blvd
Scottsdale, AZ 85259

Interoperability endpoints

  • Direct secure messaging: tkelly4724@direct.valleywisehealth.org
  • Direct secure messaging: tkelly1175710@ehrdirect.mayoclinicmsg.org

Organizations & group practices 7

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 1

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1902888985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 E WINDROSE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604829",
            "telephone_number": "480-231-0609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5777 E Mayo Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850544502",
            "country_code": "US",
            "telephone_number": "480-342-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THOMAS",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "43448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkelly1175710@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.