SAMUEL KELLY
NPI 1013542372
Anesthesiologist Assistant in Waco, TX

Q: What is Samuel Kelly's NPI number?

The NPI number for Samuel Kelly is 1013542372. It was assigned to this individual provider in the NPPES registry on March 6, 2020.

Q: What is Samuel Kelly's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Kelly was last updated on January 27, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 06, 2020Accepts Medicare Assignment

100 HILLCREST MEDICAL BLVD, WACO, TX 76712(254) 202-2000 Get Directions Write a Review

NPPES record last updated: January 27, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 27, 2022, Jul 2, 2020, Mar 6, 2020 (3 updates tracked since 2020).

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About Samuel Kelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL KELLY (NPI 1013542372) is an individual anesthesiologist assistant in Waco, Texas, licensed in Texas (32697602) and active in the NPI registry since March 2020. He is affiliated with Hillcrest Hospital and is a graduate of Other (2020).

NPPES Registry Identity

NPI1013542372

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameSAMUEL KELLY

Location Address100 HILLCREST MEDICAL BLVDWaco, TX 76712-8897

Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (254) 724-2111

Phone(254) 202-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 6, 2020

Last NPPES UpdateJanuary 27, 20223 updates tracked since enumeration

NPPES CertifiedJanuary 27, 2022

✔ NPI 1013542372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in TX · 32697602

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

100 HILLCREST MEDICAL BLVD, Waco, TX 76712

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Ohio, Inc., Blue Cross and Blue Shield of Texas, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Kelly is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345661369

PECOS Enrollment IDI20230202001108

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

19 services19 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hillcrest Hospital

Acute Care Hospitals · Mayfield Heights, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360230

Location6780 Mayfield RoadMayfield Heights, OH 44124 · Cuyahoga County

Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ISAAC LILL

Internal Medicine