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SAMUEL K KELLEY M.D.
NPI 1154368199
Psychiatry & Neurology - Child & Adolescent Psychiatry in Paducah, KY

Active since May 31, 2006PECOS EnrolledAccepts Medicare Assignment
5050I VILLAGE SQUARE DR, PADUCAH, KY 42001(270) 898-4044(270) 898-4045 Get Directions Write a Review

NPPES record last updated: August 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 22, 2026, Nov 3, 2025, May 6, 2025 and 1 more (4 updates tracked since 2025).

About Samuel K Kelley M.d. NPPES

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

SAMUEL K KELLEY M.D. (NPI 1154368199) is an individual child & adolescent psychiatry provider in Paducah, Kentucky, licensed in Kentucky (59615) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Louisville School Of Medicine (1987).

NPPES Registry Identity

NPI1154368199
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameSAMUEL K KELLEYCredential: M.D.
Location Address5050I VILLAGE SQUARE DRPaducah, KY 42001-9499
Mailing Address5050i Village Square DrPaducah, KY 42001-9499 · (270) 898-4044 · Fax (270) 898-4045
Phone(270) 898-4044
Fax(270) 898-4045
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1987
Enumeration DateMay 31, 2006
Last NPPES UpdateAugust 22, 20264 updates tracked since enumeration
NPPES CertifiedAugust 22, 2026
✔ NPI 1154368199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Licenses✔ Licensed in KY · 59615✔ Licensed in MA · 72427
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
5050I VILLAGE SQUARE DR, Paducah, KY 42001
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Other Identifiers 1

Other1154368199MA · Npi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel K Kelley M.d. 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 ID7810889813
PECOS Enrollment IDI20250501000574
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Samuel Kelley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advanced Behavioral Wellness LLC
Same address
Psychiatry
5050I VILLAGE SQUARE DR
Paducah, KY 42001
  • Reassigned Medicare billing, Kentucky enrollment
  • 2 clinicians in this Medicare group
NPI 1841049855 (270) 898-4044
Emerald Therapy Center, LLC
Same address
Community/Behavioral Health
5050 VILLAGE SQUARE DR STE B
Paducah, KY 42001
  • Reassigned Medicare billing, Kentucky enrollment
  • 15 clinicians in this Medicare group
NPI 1619340387 (270) 534-5128

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.

ADVANCED BEHAVIORAL WELLNESS LLC
Psychiatry & Neurology (Psychiatry)
5050I VILLAGE SQUARE DR
PADUCAH, KY 42001
McCracken County (270) 898-4044

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 Samuel Kelley's NPI number?

The NPI number for Samuel Kelley is 1154368199. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Where is Samuel Kelley located?

Samuel Kelley practices at 5050I Village Square Dr, Paducah, KY 42001. The listed phone number is (270) 898-4044.

What is Samuel Kelley's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Samuel Kelley enrolled in Medicare?

Yes. Samuel Kelley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samuel Kelley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Kelley reassigns Medicare benefits to 2 organizations: Advanced Behavioral Wellness LLC (Paducah, KY) and Emerald Therapy Center, LLC (Paducah, KY). Each 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 Samuel Kelley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Kelley accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Samuel Kelley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Kelley was last updated on August 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.