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DR. BRIAN D KELLY MD
NPI 1053637736
Pediatrics - Sports Medicine in Phoenix, AZ

Active since April 20, 2010PECOS Enrolled
1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-3033(602) 933-5245 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Brian D Kelly Md NPPES

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

DR. BRIAN D KELLY MD (NPI 1053637736) is an individual sports medicine provider in Phoenix, Arizona, licensed in Arizona (50745) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053637736
Entity TypeIndividualMale
Primary Taxonomy2080S0010X
Provider Legal NameDR. BRIAN D KELLYCredential: MD
Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710
Mailing Address1919 E Thomas RdPhoenix, AZ 85016-7710 · (602) 933-3033 · Fax (602) 933-5245
Phone(602) 933-3033
Fax(602) 933-5245
Sole ProprietorNo
Enumeration DateApril 20, 2010
Last NPPES UpdateJanuary 11, 2023
NPPES CertifiedJanuary 11, 2023
✔ NPI 1053637736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080S0010X
License✔ Licensed in AZ · 50745
Definition
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedPediatricsTaxonomy 208000000X · License 50745 (AZ), 258848 (MA)
1919 E THOMAS RD, Phoenix, AZ 85016
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Other Identifiers 1

Medicaid040502AZ

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Brian D 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 Brian Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Phoenix Children's Hospital
Same address
Pediatrics
1919 E THOMAS RD
Phoenix, AZ 85016
  • Reassigned Medicare billing, Arizona enrollment
  • 1,416 clinicians in this Medicare group
NPI 1922112044 (602) 933-1000

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

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. TIMUR RAGHIB M.D.
Hospitalist
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0777
MRS. MARIA T ESCOBAR CSP, RD
Dietitian, Registered
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (480) 440-2787
DR. AHMAR HUSAIN MD
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
MRS. SOLEE R COWLEY LCSW
Social Worker (Clinical)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0414
MR. SEAN PATRICK BRADY DO
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
PRIYA PRASHER M.D.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1900
DR. AMIT RAJARAM D.O.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0198
LAURA GARDNER HAMANT
Pediatrics (Pediatric Gastroenterology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1000

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 Brian Kelly's NPI number?

The NPI number for Brian Kelly is 1053637736. It was assigned to this individual provider in the NPPES registry on April 20, 2010.

Where is Brian Kelly located?

Brian Kelly practices at 1919 E Thomas Rd, Phoenix, AZ 85016. The listed phone number is (602) 933-3033.

What is Brian Kelly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Is Brian Kelly enrolled in Medicare?

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

Which organization bills Medicare for Brian Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Kelly reassigns Medicare benefits to Phoenix Children's Hospital (Phoenix, AZ). 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 Brian 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 Brian Kelly was last updated on January 11, 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.