MARYANN KELLY M.D.
NPI 1033640206
Internal Medicine in Park Ridge, IL

Q: What is Maryann Kelly's NPI number?

The NPI number for Maryann Kelly is 1033640206. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Q: What is Maryann Kelly's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: Is Maryann Kelly enrolled in Medicare?

No. Maryann Kelly has opted out of Medicare through November 29, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Maryann Kelly was last updated on June 22, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 21, 2017Opted out of Medicare · through Nov 29, 2026

1775 BALLARD RD, PARK RIDGE, IL 60068(847) 318-9340 Get Directions Write a Review

NPPES record last updated: June 22, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 22, 2017, Mar 21, 2017 (2 updates tracked since 2017).

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About Maryann Kelly M.d. NPPES

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

MARYANN KELLY M.D. (NPI 1033640206) is an individual internal medicine provider in Park Ridge, Illinois, licensed in Illinois (125.071353) and active in the NPI registry since March 2017. She has opted out of Medicare through November 29, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1033640206

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameMARYANN KELLYCredential: M.D.

Location Address1775 BALLARD RDPark Ridge, IL 60068-1005

Mailing Address1775 Ballard RdPark Ridge, IL 60068-1005 · (847) 318-9340

Phone(847) 318-9340

Sole ProprietorNo

Enumeration DateMarch 21, 2017

Last NPPES UpdateJune 22, 20172 updates tracked since enumeration

✔ NPI 1033640206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 125.071353

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1775 BALLARD RD, Park Ridge, IL 60068

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Maryann Kelly M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 29, 2024 through November 29, 2026.

Opt-Out Effective DateNovember 29, 2024

Opt-Out In Effect ThroughNovember 29, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Areas of Expertise CMS Part B claims 3

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

73 services69 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

45 services45 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60068 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers16 claims38 services$6.09 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

DANIELLE ALYSSA WALES MD

Family Medicine