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DR. MARY ALICE KELLY MD
NPI 1053361816
Internal Medicine in West Seneca, NY

Active since May 11, 2006PECOS Enrolled
1900 RIDGE RD, STE 130, WEST SENECA, NY 14224(716) 675-0707(716) 961-3706 Get Directions Write a Review

NPPES record last updated: October 19, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mary Alice Kelly Md NPPES

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

DR. MARY ALICE KELLY MD (NPI 1053361816) is an individual internal medicine provider in West Seneca, New York, licensed in New York (1568631) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053361816
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. MARY ALICE KELLYCredential: MD
Location Address1900 RIDGE RD, STE 130West Seneca, NY 14224-3332
Mailing Address1900 Ridge Rd, Ste130West Seneca, NY 14224-3332 · (716) 675-0707 · Fax (716) 961-3706
Phone(716) 675-0707
Fax(716) 961-3706
Sole ProprietorNo
Enumeration DateMay 11, 2006
Last NPPES UpdateOctober 19, 2012
✔ NPI 1053361816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 1568631
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.
1900 RIDGE RD, West Seneca, NY 14224
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Other Identifiers 5

Other000500738001Bcbs
Medicare UPIND01420
Other0401537Iha
Other00010089201Univera
Medicare ID-Type UnspecifiedB77781

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Alice Kelly Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trinity Medical Wny PC
6.1 mi
Internal Medicine
144 GENESSE STREET
Buffalo, NY 14203
  • Reassigned Medicare billing, New York enrollment
  • 332 clinicians in this Medicare group
NPI 1295043149 (716) 206-1503

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14224 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 3

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
6 suppliers11 claims29 services$6.00 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier30 claims30 services$67.45 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers16 claims16 services$24.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. KIMBERLY M ODDO M.D.
Family Medicine
1900 RIDGE RD
WEST SENECA, NY 14224
Erie County (716) 712-0670
DR. TIMOTHY FRANCIS GABRYEL MD
Internal Medicine
1900 RIDGE RD, STE 130
WEST SENECA, NY 14224
Erie County (716) 675-0707
IRENE P ROZMUS ANP
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1900 RIDGE RD, MEDICAL ASSOCIATES SOUTHTOWNS PC
WEST SENECA, NY 14224
Erie County (716) 675-3754
TIMOTHY F GABRYEL MD PC
Non-Pharmacy Dispensing Site
1900 RIDGE RD, SUITE 130
BUFFALO, NY 14224
Erie County (716) 675-0707
RICHARD E ZIARKOWSKI DC
Chiropractor
1900 RIDGE RD
WEST SENECA, NY 14224
Erie County (716) 677-2969
LYNDA JOY FRANCIS RPAC
Physician Assistant
1900 RIDGE RD, STE 130
WEST SENECA, NY 14224
Erie County (716) 675-0707
KRISTY LYNNE MCDONALD LMT
Massage Therapist
1900 RIDGE RD, STE 127
WEST SENECA, NY 14224
Erie County (716) 677-2969
SENECA OPTICAL INC.
Optometrist (Corneal and Contact Management)
1900 RIDGE RD, SUITE 101
WEST SENECA, NY 14224
Erie County (716) 677-9800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Kelly's NPI number?

The NPI number for Mary Kelly is 1053361816. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Where is Mary Kelly located?

Mary Kelly practices at 1900 Ridge Rd Ste 130, West Seneca, NY 14224. The listed phone number is (716) 675-0707.

What is Mary Kelly's specialty?

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

Is Mary Kelly enrolled in Medicare?

Yes. Mary Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Kelly reassigns Medicare benefits to Trinity Medical Wny PC (Buffalo, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Kelly was last updated on October 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.