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KELLEY C BOOTH NP
NPI 1053830851
Nurse Practitioner - Family in Berkeley, CA

Active since September 12, 2017PECOS Enrolled
2850 TELEGRAPH AVE STE 120, BERKELEY, CA 94705(510) 204-8140 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 7, 2023, Jul 21, 2022, Aug 2, 2019 and 2 more (5 updates tracked since 2017).

About Kelley C Booth Np NPPES

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

KELLEY C BOOTH NP (NPI 1053830851) is an individual family provider in Berkeley, California, licensed in California (95007295) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053830851
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLEY C BOOTHCredential: NP
Location Address2850 TELEGRAPH AVE STE 120Berkeley, CA 94705-1159
Mailing Address325 Distel CirLos Altos, CA 94022-1408 · (510) 204-8290 · Fax (510) 506-7725
Phone(510) 204-8140
Sole ProprietorNo
Enumeration DateSeptember 12, 2017
Last NPPES UpdateMarch 7, 20235 updates tracked since enumeration
✔ NPI 1053830851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95007295
2850 TELEGRAPH AVE STE 120, Berkeley, CA 94705
Open in Google Maps ↗

Other Identifiers 1

OtherNP95007295CA · State Medical License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelley C Booth Np 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 Kelley Booth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Snf Wound Care
340 mi
Internal Medicine
11270 EXPOSITION BLVD FL 1, BOX: 641519
Los Angeles, CA 90064
  • Reassigned Medicare billing, California enrollment
  • 75 clinicians in this Medicare group
NPI 1114393311 (833) 379-6863

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 94705 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

Other Providers at the Same Location NPPES 10

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

DR. KOVID TRIVEDI M.B.B.S.
Internal Medicine (Pulmonary Disease)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-1844
DR. JENNIFER AULT M.S., D.P.T., D.O.
Psychiatry & Neurology (Pain Medicine)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8150
VICTOR SAM WANG
Psychiatry & Neurology (Neurology)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140
DR. VISWAM SIVA NAIR MD
Internal Medicine (Pulmonary Disease)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140
MICHAEL TAM
Physician Assistant
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140
CHRISTINA KWAN MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140
SEPEHR REJAI M.D.
Pain Medicine (Pain Medicine)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140
DR. ZACHARY CLIFFORD LANDMAN M.D.
Pain Medicine (Interventional Pain Medicine)
2850 TELEGRAPH AVE STE 120
BERKELEY, CA 94705
Alameda County (510) 204-8140

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 Kelley Booth's NPI number?

The NPI number for Kelley Booth is 1053830851. It was assigned to this individual provider in the NPPES registry on September 12, 2017.

Where is Kelley Booth located?

Kelley Booth practices at 2850 Telegraph Ave Ste 120, Berkeley, CA 94705. The listed phone number is (510) 204-8140.

What is Kelley Booth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelley Booth enrolled in Medicare?

Yes. Kelley Booth is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelley Booth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Booth reassigns Medicare benefits to Snf Wound Care (Los Angeles, CA). 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 Kelley Booth'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 Kelley Booth 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.