KRISTEN KELLY
NPI 1093857005
Specialist in Mexico, NY
About Kristen Kelly NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRISTEN KELLY (NPI 1093857005) is an individual specialist in Mexico, New York, licensed in New York (0263941) and active in the NPI registry since February 2007.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kristen Kelly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kristen Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Watertown, NY 13601
- Reassigned Medicare billing, New York enrollment
- 11 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kristen Kelly's NPI number?
The NPI number for Kristen Kelly is 1093857005. It was assigned to this individual provider in the NPPES registry on February 13, 2007.
Where is Kristen Kelly located?
Kristen Kelly practices at 216 Co Rt 64, Mexico, NY 13114. The listed phone number is (315) 963-5421.
What is Kristen Kelly's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Kristen Kelly enrolled in Medicare?
Yes. Kristen Kelly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kristen Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kristen Kelly reassigns Medicare benefits to Cani Pt Ot Slp & Psychology PLLC (Watertown, NY). 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 Kristen Kelly'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 Kristen Kelly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Kristen Kelly · NPI 1093857005
Specialist provider in Mexico, New York. Individual provider, active in the CMS NPPES registry since February 13, 2007.
## Identity
- **NPI:** 1093857005 (Entity type: Individual)
- **Enumerated:** February 13, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **State license:** 0263941 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 216 CO RT 64, Mexico, NY 13114
- **Phone:** (315) 963-5421
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Cani Pt Ot Slp & Psychology PLLC (NPI 1114065174, Watertown, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1093857005) · Data from the CMS NPPES public registry.