BYRON THOMAS KELLY M.D.
NPI 1033280466
Family Medicine in Decatur, GA
NPI Status: Active since November 09, 2006
Contact Information
445 WINN WAY
DECATUR, GA
ZIP 30030
Phone: (404) 294-3835
Fax: (404) 508-7795
- Individual
- Male
- Years of Experience 38
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About BYRON KELLY
This page provides the complete NPI Profile along with additional information for Byron Kelly, a primary care provider established in Decatur, Georgia with a medical specialization in Family Medicine and more than 38 years of experience. He graduated from Meharry Medical College School Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1033280466 assigned on November 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 032762 (GA). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1033280466
- Provider Name
- BYRON THOMAS KELLY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 445 WINN WAY DECATUR, GA 30030
- Location Phone
- (404) 294-3835
- Location Fax
- (404) 508-7795
- Mailing Address
- 445 WINN WAY DECATUR, GA 30030
- Mailing Phone
- (404) 294-3835
- Mailing Fax
- (404) 508-7795
- Medical School Name
- MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
- Graduation Year
- 1988
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-09-2006
- Last Update Date
- 01-30-2016
- Code Navigator
A primary care provider (PCP) like Byron Kelly sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 032762
- License State
- GA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
- Bronze Simple Diabetes | with Bryan Health - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | with Bryan Health - EPO
- Gold Elite - EPO
- Gold Elite | with Bryan Health - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard | with Bryan Health - EPO
- Silver Simple Diabetes - EPO
- Silver Simple Diabetes | with Bryan Health - EPO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver | with Bryan Health - EPO
- Silver Simple Women's Health with Menopause Benefits | with Bryan Health - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E77495 | MEDICARE UPIN (02) | GA | |
| 00455749A | MEDICAID (05) | GA | |
| 08BBTFJ | MEDICARE ID-TYPE UNSPECIFIED (04) | GA |
Medicare Participation & PECOS Enrollment Status
Byron Kelly is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Byron Kelly is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1456376888
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20051013000926
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.01 for a new patient copayment and $25.05 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 30030 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.06
- Minimum New Patient Price $56.84
- Maximum New Patient Price $172.43
- Average New Patient Copayment $22.01
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.1
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.2
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $140.4
- Average Established Patient Copayment $25.05
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $35.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1033280466, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DECATUR, GA 30030
DECATUR, GA 30030
DECATUR, GA 30030
DECATUR, GA 30030
DECATUR, GA 30030
DECATUR, GA 30030
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033280466, enumerated as an "individual" on November 09, 2006.
The provider is located at 445 WINN WAY DECATUR, GA 30030 and the phone number is (404) 294-3835.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Oscar Insurance Company, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
