DEREK KEITH KELLY MD
NPI 1164622007
Emergency Medicine in Fort Worth, TX

Q: What is Derek Kelly's NPI number?

The NPI number for Derek Kelly is 1164622007. It was assigned to this individual provider in the NPPES registry on July 19, 2007.

Q: What is Derek Kelly's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Kelly was last updated on June 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 19, 2007PECOS Enrolled

1400 8TH AVE, FORT WORTH, TX 76104(817) 922-7070 Get Directions Write a Review

NPPES record last updated: June 21, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Derek Keith Kelly Md NPPES

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

DEREK KEITH KELLY MD (NPI 1164622007) is an individual emergency medicine provider in Fort Worth, Texas, licensed in Texas (N1708) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164622007

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDEREK KEITH KELLYCredential: MD

Location Address1400 8TH AVEFort Worth, TX 76104-4110

Mailing Address1400 8th AveFort Worth, TX 76104-4110 · (817) 922-7070

Phone(817) 922-7070

Sole ProprietorNo

Enumeration DateJuly 19, 2007

Last NPPES UpdateJune 21, 2012

✔ NPI 1164622007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in TX · N1708

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

1400 8TH AVE, Fort Worth, TX 76104

Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Keith Kelly Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Derek Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Texas Medicine Resources, LLP

7.7 mi

Emergency Medicine

6451 BRENTWOOD STAIR RD, SUITE 200
Fort Worth, TX 76112

Reassigned Medicare billing, Texas enrollment
545 clinicians in this Medicare group

NPI 1376581900 (817) 496-9700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

373 services363 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

214 services204 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

104 services102 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

14 services14 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

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.

JOEY MAYOR MD

Emergency Medicine