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DR. KELLY MAH M.D.
NPI 1053420489
Obstetrics & Gynecology in Manteca, CA

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment
1205 E NORTH ST, MANTECA, CA 95336(209) 612-9077(209) 824-0754 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 7, 2023, Apr 7, 2022 (2 updates tracked since 2022).

About Dr. Kelly Mah M.d. NPPES

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

DR. KELLY MAH M.D. (NPI 1053420489) is an individual obstetrics & gynecology provider in Manteca, California, licensed in California (G065156) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Manteca, and is a graduate of Albert Einstein College Of Medicine Of Yeshiva University (1983).

NPPES Registry Identity

NPI1053420489
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. KELLY MAHCredential: M.D.
Location Address1205 E NORTH STManteca, CA 95336-4932
Mailing AddressPo Box 993Manteca, CA 95336-1139 · (209) 612-9077
Phone(209) 612-9077
Fax(209) 824-0754
Sole ProprietorNo
Medical School CMSAlbert Einstein College Of Medicine Of Yeshiva UniversityGraduated 1983
Enumeration DateAugust 30, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedNovember 23, 2020
✔ NPI 1053420489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in CA · G065156
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1205 E NORTH ST, Manteca, CA 95336
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Secondary Practice Location 1

Location 11191 E Yosemite Ave Ste CManteca, CA 95336-5071 · Phone (209) 824-2202 · Fax (209) 824-2205

Other Identifiers 2

MedicaidGR0045320CA
OtherG065156CA · Medical License Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly Mah M.d. 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 ID9335556984
PECOS Enrollment IDI20210325002111
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 Reassignments

2

Medicare enrollment records show Kelly Mah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dhp Of California Medical Group Inc
13 mi
Obstetrics & Gynecology
1800 N CALIFORNIA ST
Stockton, CA 95204
  • Reassigned Medicare billing, California enrollment
  • 83 clinicians in this Medicare group
NPI 1679836084 (209) 943-2000
P. Gill Obstetrics & Gynecology Medical Group, Inc.
23 mi
Obstetrics & Gynecology
999 S FAIRMONT AVE, STE 230
Lodi, CA 95240
  • Reassigned Medicare billing, California enrollment
  • 19 clinicians in this Medicare group
NPI 1386636165 (209) 465-5550

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 95336 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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 20

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

TAMMIE NGOC TU NGUYEN PHARM.D.
Pharmacist
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (209) 239-8381
CALIFORNIA EM-I MEDICAL SERVICES, A MEDICAL CORPORATION
Emergency Medicine
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (469) 401-2386
PATRICIA KAIDA SAKAI PHARM D
Pharmacist
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (209) 239-8381
HONEYCOMB MEDICAL SERVICES, A MED CORP
Emergency Medicine
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (469) 401-2386
SAHIL RAO MD
Internal Medicine
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (512) 850-5565
DR. SALLY TSUNEKAWA PHARM D
Pharmacist
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (209) 239-8381
JASLEEN KAUR DHALIWAL
Nurse Practitioner (Family)
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (951) 973-2033
MS. JAYSHREE MAHESH MODI RPH
Pharmacist
1205 E NORTH ST
MANTECA, CA 95336
San Joaquin County (209) 239-8381

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 Kelly Mah's NPI number?

The NPI number for Kelly Mah is 1053420489. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Kelly Mah located?

Kelly Mah practices at 1205 E North St, Manteca, CA 95336. The listed phone number is (209) 612-9077.

What is Kelly Mah's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kelly Mah enrolled in Medicare?

Yes. Kelly Mah is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Mah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Mah reassigns Medicare benefits to 2 organizations: Dhp Of California Medical Group Inc (Stockton, CA) and P. Gill Obstetrics & Gynecology Medical Group, Inc. (Lodi, CA). Each 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 Kelly Mah'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 Kelly Mah was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.