PHILLIP ANTONIO KELLEY PA-C
NPI 1083055396
Physician Assistant in Winston Salem, NC

Q: What is Phillip Kelley's NPI number?

The NPI number for Phillip Kelley is 1083055396. It was assigned to this individual provider in the NPPES registry on July 15, 2013.

Q: What is Phillip Kelley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Kelley was last updated on July 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 15, 2013PECOS EnrolledAccepts Medicare Assignment

390 W SALEM AVE, WINSTON SALEM, NC 27101(336) 721-2375(336) 721-2394 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 18, 2022, Aug 18, 2021, Aug 9, 2021 and 5 more (8 updates tracked since 2017).

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About Phillip Antonio Kelley Pa-c NPPES

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

PHILLIP ANTONIO KELLEY PA-C (NPI 1083055396) is an individual physician assistant in Winston Salem, North Carolina, licensed in North Carolina (0010-04383) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with Novant Health Forsyth Medical Center, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1083055396

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NamePHILLIP ANTONIO KELLEYCredential: PA-C

Location Address390 W SALEM AVEWinston Salem, NC 27101-5861

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(336) 721-2375

Fax(336) 721-2394

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 15, 2013

Last NPPES UpdateJuly 18, 20228 updates tracked since enumeration

NPPES CertifiedJuly 18, 2022

✔ NPI 1083055396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-04383

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

390 W SALEM AVE, Winston Salem, NC 27101

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Secondary Practice Locations 5

Location 11904 Jake Alexander Blvd W Ste 301Salisbury, NC 28147-1177 · Phone (704) 638-1551 · Fax (704) 638-1553

Location 2794 S Main St Ste BKernersville, NC 27284-4074 · Phone (336) 904-2317 · Fax (336) 443-6030

Location 31977 Cotton Grove RdLexington, NC 27292-5721 · Phone (336) 243-3000 · Fax (336) 243-3012

Location 4250 Charlois BlvdWinston Salem, NC 27103-1508 · Phone (336) 718-1000 · Fax (336) 718-1065

Location 52452 Fairlawn CtWinston Salem, NC 27106-3884 · Phone (336) 443-9910 · Fax (336) 443-9909

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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

Phillip Antonio Kelley Pa-c 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 ID1759515190

PECOS Enrollment IDI20131017001705

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 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

86 services55 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.

37 services29 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

31 services31 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

21 services19 patients

Hospital Affiliations CMS Care Compare

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

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340014

Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27101 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

77%102 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

55%137 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

41%160 patients2/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

48%73 patients2/55-star benchmark: 98%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

1%87 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 12

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

DR. JONATHAN CHARLES LEE MACK MD

Family Medicine