MICK KELLY MD
NPI 1053793208
Orthopaedic Surgery in Pewaukee, WI

Active since June 24, 2015PECOS EnrolledAccepts Medicare Assignment
N15W28300 GOLF RD, PEWAUKEE, WI 53072(262) 303-5055(262) 303-5057 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 14, 2021, Jul 27, 2021, Jun 2, 2020 (3 updates tracked since 2020).

About Mick Kelly Md NPPES

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

MICK KELLY MD (NPI 1053793208) is an individual orthopaedic surgery provider in Pewaukee, Wisconsin, licensed in Wisconsin (75716) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1053793208
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameMICK KELLYCredential: MD
Location AddressN15W28300 GOLF RDPewaukee, WI 53072-4800
Mailing AddressN15w28300 Golf RdPewaukee, WI 53072-4800 · (262) 303-5055 · Fax (262) 303-5057
Fax(262) 303-5057
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2015
Enumeration DateJune 24, 2015
Last NPPES UpdateDecember 14, 20213 updates tracked since enumeration
NPPES CertifiedDecember 14, 2021
NPI 1053793208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses Licensed in WI · 75716 Licensed in IL · 125066593
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryTaxonomy 207XS0114X · License 11729390-1205 (UT)
N15W28300 GOLF RD, Pewaukee, WI 53072

Secondary Practice Location 1

Location 1590 S Wakara WaySalt Lake City, UT 84108-1200 · Phone (801) 587-5400

Accepted 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

Mick Kelly Md 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 ID5294025029
PECOS Enrollment IDI20210809000856
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.

Areas of Expertise CMS Part B claims 16

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.

Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg J7329
Trivisc is a treatment involving injections of a substance called hyaluronan into your joint, typically the knee. This substance is similar to a natural fluid in your joints that helps cushion and lubricate them. Trivisc can help reduce pain and improve joint movement.
4,125 services37 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
784 services68 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
249 services121 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.
204 services154 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
190 services36 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
131 services92 patients

Hospital Affiliations CMS Care Compare 2

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Oconomowoc Memorial Hospital

Acute Care Hospitals · Oconomowoc, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520062
Location791 E Summit AveOconomowoc, WI 53066 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53072 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

Clinic/Center (Ambulatory Surgical)
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Physical Therapist
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Orthopaedic Surgery
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Anesthesiology
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Orthopaedic Surgery
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Physical Therapist
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Orthopaedic Surgery
N15W28300 GOLF RD
PEWAUKEE, WI 53072
Nurse Practitioner
N15W28300 GOLF RD
PEWAUKEE, WI 53072

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 Mick Kelly's NPI number?

The NPI number for Mick Kelly is 1053793208. It was assigned to this individual provider in the NPPES registry on June 24, 2015.

Where is Mick Kelly located?

Mick Kelly practices at N15w28300 Golf Rd, Pewaukee, WI 53072. The listed phone number is (262) 303-5055.

What is Mick Kelly's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Mick Kelly enrolled in Medicare?

Yes. Mick Kelly 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.

What insurance does Mick Kelly accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and UnitedHealthcare list Mick Kelly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mick Kelly affiliated with any hospitals?

According to CMS data, Mick Kelly is affiliated with Waukesha Memorial Hospital and Oconomowoc Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mick Kelly was last updated on December 14, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.