CODY KELLEY PA-C
NPI 1033927462
Physician Assistant in Chicago, IL

Q: What is Cody Kelley's NPI number?

The NPI number for Cody Kelley is 1033927462. It was assigned to this individual provider in the NPPES registry on December 18, 2024.

Q: What is Cody Kelley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Cody Kelley was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 18, 2024PECOS EnrolledAccepts Medicare Assignment

676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611(312) 695-1800(312) 695-1394 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 6, 2026, Jul 7, 2025, Dec 18, 2024 (3 updates tracked since 2024).

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About Cody Kelley Pa-c NPPES

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

CODY KELLEY PA-C (NPI 1033927462) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085011522) and active in the NPI registry since December 2024. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1033927462

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameCODY KELLEYCredential: PA-C

Location Address676 N SAINT CLAIR ST STE 14-044Chicago, IL 60611-2927

Mailing Address676 N Saint Clair St Ste 14-044Chicago, IL 60611-2927 · (312) 695-1800 · Fax (312) 695-1394

Phone(312) 695-1800

Fax(312) 695-1394

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateDecember 18, 2024

Last NPPES UpdateFebruary 6, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 6, 2026

✔ NPI 1033927462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085011522

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

676 N SAINT CLAIR ST STE 14-044, Chicago, IL 60611

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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

Cody Kelley Pa-c 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 ID9537676192

PECOS Enrollment IDI20260113002048

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

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

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140281

Location251 E Huron StChicago, IL 60611 · Cook County

Emergency services Birthing friendly

Eaton Rapids Medical Center

Critical Access Hospitals · Eaton Rapids, MI

OwnershipVoluntary non-profit - Private

CMS Certification Number231324

Location1500 S Main StreetEaton Rapids, MI 48827 · Eaton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60611 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

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

Other Providers at the Same Location NPPES 15

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

SAMANTHA PERI RUSH APRN, CNP

Nurse Practitioner