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PAULO KELLY DO
NPI 1124966296
Student in an Organized Health Care Education/Training Program in Idaho Falls, ID

Active since March 23, 2026PECOS Enrolled
3100 CHANNING WAY, IDAHO FALLS, ID 83404(208) 529-6111 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paulo Kelly Do NPPES

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

PAULO KELLY DO (NPI 1124966296) is an individual student in an organized health care education/training program in Idaho Falls, Idaho and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124966296
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePAULO KELLYCredential: DO
Location Address3100 CHANNING WAYIdaho Falls, ID 83404-7533
Mailing Address3100 Channing WayIdaho Falls, ID 83404-7533 · (208) 529-6111
Phone(208) 529-6111
Sole ProprietorYes
Enumeration DateMarch 23, 2026
NPPES CertifiedMarch 22, 2026
✔ NPI 1124966296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3100 CHANNING WAY, Idaho Falls, ID 83404
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paulo Kelly Do 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.

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.

CARL SAMUEL BRAYTON DO
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (714) 616-4454
REED D LOERTSCHER CRNA
Nurse Anesthetist, Certified Registered
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 529-6285
ALEXIS R SIDDOWAY NP
Nurse Practitioner (Neonatal)
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 535-4432
UNIVERSITY OF UTAH ADULT SERVICES
Internal Medicine (Nephrology)
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (801) 581-2121
MR. VENKATA KALYAN C BYRAPOGU MD
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 970-1123
TAYLOR JAMES CARSON
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 670-0407
NOOR ASHRAF NASSEF DO
Student in an Organized Health Care Education/Training Program
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 529-6111
DR. ALAN B WRAY M.D.
Radiology (Diagnostic Radiology)
3100 CHANNING WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 227-2600

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 Paulo Kelly's NPI number?

The NPI number for Paulo Kelly is 1124966296. It was assigned to this individual provider in the NPPES registry on March 23, 2026.

Where is Paulo Kelly located?

Paulo Kelly practices at 3100 Channing Way, Idaho Falls, ID 83404. The listed phone number is (208) 529-6111.

What is Paulo Kelly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Paulo Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Paulo Kelly was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.