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KELLY MAUREEN HOLT
NPI 1205169711
Nurse Practitioner - Adult Health in San Diego, CA

Active since September 15, 2009PECOS EnrolledAccepts Medicare Assignment
4060 4TH AVE STE 100, SAN DIEGO, CA 92103(619) 718-9444(619) 718-9440 Get Directions Write a Review

NPPES record last updated: October 3, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kelly Maureen Holt NPPES

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

KELLY MAUREEN HOLT (NPI 1205169711) is an individual adult health provider in San Diego, California, licensed in California (18175) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1205169711
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameKELLY MAUREEN HOLT
Location Address4060 4TH AVE STE 100San Diego, CA 92103-2120
Mailing Address4060 4th Ave Ste 100San Diego, CA 92103 · (619) 718-9444 · Fax (619) 718-9440
Phone(619) 718-9444
Fax(619) 718-9440
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateSeptember 15, 2009
Last NPPES UpdateOctober 3, 2011
✔ NPI 1205169711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in CA · 18175
4060 4TH AVE STE 100, San Diego, CA 92103
Open in Google Maps ↗

Other Names 1

Other Name (5)Kelly Maureen Reck Np

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Maureen Holt 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 ID7012195621
PECOS Enrollment IDI20171103000784
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.

Areas of Expertise CMS Part B claims 9

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
544 services372 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
115 services115 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
62 services60 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
52 services47 patients
Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005
An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.
27 services26 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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

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

DR. NIRMAL PATEL PHARMD
Pharmacist
4060 4TH AVE STE 100
SAN DIEGO, CA 92103
San Diego County (858) 964-1013

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 Kelly Holt's NPI number?

The NPI number for Kelly Holt is 1205169711. It was assigned to this individual provider in the NPPES registry on September 15, 2009. The provider is also known as Kelly Maureen Reck Np.

Where is Kelly Holt located?

Kelly Holt practices at 4060 4th Ave Ste 100, San Diego, CA 92103. The listed phone number is (619) 718-9444.

What is Kelly Holt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kelly Holt enrolled in Medicare?

Yes. Kelly Holt 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.

When was this NPI record last updated?

The NPPES record for Kelly Holt was last updated on October 3, 2011. 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.