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

Q: 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.

Q: What is Kelley Booth's specialty?

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

Q: 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.

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: August 02, 2026.

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

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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

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Other Identifiers 1

OtherNP95007295CA · State Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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.

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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.

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