Individual provider Active NPI

Kelly Donnelly Mueller, D.O.

  • Neurology Physician
  • Sheboygan, WI
National Provider Identifier
1932369923
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
22300-875 Issued in WI
Practice address
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone
(920) 457-4461
NPI assigned
Jun 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 268837 NY
Neurology Physician 2084N0400X 22300-875 WI Primary

Addresses

Primary practice location

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129

Mailing address

47 New Scotland Ave # MC70
Albany, NY 12208-3412

Other practice location 1

47 New Scotland Ave
Preliminary Medicine (Neurology)
Albany, NY 12208-3412
Phone (518) 262-3125

Other identifiers 1

IdentifierTypeStateIssuer
100199202MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kdonnellymueller340391@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131021001256 NY Practitioner - Neurology 3375778723 Reassigns benefits to 1 organization
I20230506000104 TX Practitioner - Neurology 3375778723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268837NYMDNeurology Physician
22300-875WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince May 2, 2022 Accepting new patients
Baycare Aurora, LLC CurrentSince Oct 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 2, 2022 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Aug 13, 2023 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Aug 13, 2023 Accepting new patients
Albany Medical College Neurology CurrentSince Aug 1, 2020 Accepting new patients
Albany Medical College Neurology CurrentSince Oct 1, 2013 Accepting new patients
Albany Medical College CurrentSince Oct 1, 2013 Accepting new patients
Albany Medical College Current Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Jan 20, 2023 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Albany Medical College CurrentSince Jul 17, 2022 Accepting new patients
Albany Medical College PastSince Jul 17, 2022 Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

453 Pine Grove Rd
Hays, MT 59527
Phone (406) 353-3190

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#70
Albany, NY 12208
Phone (518) 262-5226

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Interoperability endpoints

  • Direct secure messaging: kdonnellymueller24105@albanymed.direct-ci.com
  • Direct secure messaging: kdonnellymueller340391@direct.myadvocateaurora.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1932369923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE # MC70",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813129",
            "telephone_number": "920-457-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Preliminary Medicine (Neurology)",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY MUELLER",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "268837",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "22300-875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100199202",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdonnellymueller340391@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.