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MICHAEL JOHN KELLY M.D.
NPI 1093785586
Family Medicine in Tacoma, WA

Active since January 25, 2006PECOS Enrolled
9040 JACKSON AVE, TACOMA, WA 98431(253) 982-7084 Get Directions Write a Review

NPPES record last updated: March 13, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michael John Kelly M.d. NPPES

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

MICHAEL JOHN KELLY M.D. (NPI 1093785586) is an individual family medicine provider in Tacoma, Washington, licensed in Washington (26546) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Joint Base Lewis Mcchord.

NPPES Registry Identity

NPI1093785586
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMICHAEL JOHN KELLYCredential: M.D.
Location Address9040 JACKSON AVETacoma, WA 98431-1303
Mailing Address9040 Jackson AveTacoma, WA 98431-0001 · (253) 982-7084 · Fax (253) 968-3278
Phone(253) 982-7084
Sole ProprietorNo
Enumeration DateJanuary 25, 2006
Last NPPES UpdateMarch 13, 2019
✔ NPI 1093785586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WA · 26546
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9040 JACKSON AVE, Tacoma, WA 98431
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Secondary Practice Location 1

Location 1690 Barnes BlvdJoint Base Lewis McChord, WA 98438-1303 · Phone (253) 982-7084 · Fax (253) 968-3278

Other Identifiers 1

Other930712715Tax Id#

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael John Kelly M.d. 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 98431 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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 20

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

MICHAEL JOHN MEANS CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2235
DR. ADAM CLAY PERKINS PH.D.
Psychologist (Clinical)
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-3071
GABRIELLE ABRAHAMSEN DPT
Physical Therapist
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2220
KENNY VAN LE MD
Anesthesiology
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1110
MR. ANDREW J IRIZARRY DNP, CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (330) 509-3934
MATTHEW LIBID CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (203) 768-5053
DR. SALEEM M CHOUDRY
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2462
COURTNEY LAVIN
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1790

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 Michael Kelly's NPI number?

The NPI number for Michael Kelly is 1093785586. It was assigned to this individual provider in the NPPES registry on January 25, 2006.

Where is Michael Kelly located?

Michael Kelly practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 982-7084.

What is Michael Kelly's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Michael Kelly was last updated on March 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.