1. Home
  2. Directory
  3. Idaho
  4. Coeur D Alene
  5. Physician Assistant
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TRACEY DAWN KELLY PA-C
NPI 1184554230
Physician Assistant in Coeur D Alene, ID

Active since May 20, 2026PECOS Enrolled
700 W IRONWOOD DR STE 350, COEUR D ALENE, ID 83814(208) 625-5222 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 24, 2026, Jul 29, 2026, May 20, 2026 (3 updates tracked since 2026).

About Tracey Dawn Kelly Pa-c NPPES

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

TRACEY DAWN KELLY PA-C (NPI 1184554230) is an individual physician assistant in Coeur D Alene, Idaho, licensed in Idaho (2881912) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Coeur D Alene.

NPPES Registry Identity

NPI1184554230
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTRACEY DAWN KELLYCredential: PA-C
Location Address700 W IRONWOOD DR STE 350Coeur D Alene, ID 83814-4487
Mailing Address6840 N Verlaine DrCoeur D Alene, ID 83815-8110 · (208) 215-5723
Phone(208) 625-5222
Sole ProprietorYes
Enumeration DateMay 20, 2026
Last NPPES UpdateAugust 24, 20263 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1184554230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · 2881912
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
700 W IRONWOOD DR STE 350, Coeur D Alene, ID 83814
Open in Google Maps ↗

Secondary Practice Location 1

Location 1700 W Ironwood Dr Ste 341Coeur D Alene, ID 83814-4404 · Phone (208) 625-5222 · Fax (208) 625-5223

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tracey Dawn Kelly Pa-c 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 83814 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
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 13

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

PABLO FERNANDO MICHEL SANCHEZ M.D.
Internal Medicine (Cardiovascular Disease)
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5250
AARON J NOTESTINE M.D.
Internal Medicine (Cardiovascular Disease)
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5250
MRS. CHARLOTTE RENE BROESCH ARNP-CNP
Nurse Practitioner
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5230
CONNIE KEIBLER ARNP
Nurse Practitioner
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5250
LISA KAY FREDRICK NP
Nurse Practitioner
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5230
MICHAEL MOHR PA
Physician Assistant
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 676-9913
MATTHEW LAURITZ LOW MD
Surgery (Vascular Surgery)
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5222
DAVID JAMES FREMOUW PA-C
Physician Assistant
700 W IRONWOOD DR STE 350
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5222

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 Tracey Kelly's NPI number?

The NPI number for Tracey Kelly is 1184554230. It was assigned to this individual provider in the NPPES registry on May 20, 2026.

Where is Tracey Kelly located?

Tracey Kelly practices at 700 W Ironwood Dr Ste 350, Coeur D Alene, ID 83814. The listed phone number is (208) 625-5222.

What is Tracey Kelly's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tracey Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tracey Kelly was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.