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DR. RUSSELL PHELPS KELLEY IV M.D.
NPI 1215375373
Radiology - Diagnostic Radiology in Dallas, TX

Active since June 11, 2013PECOS EnrolledAccepts Medicare Assignment
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219(510) 689-9500(877) 880-2039 Get Directions Write a Review

NPPES record last updated: December 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 20, 2024, Nov 19, 2024, Sep 10, 2024 and 1 more (4 updates tracked since 2024).

About Dr. Russell Phelps Kelley Iv M.d. NPPES

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

DR. RUSSELL PHELPS KELLEY IV M.D. (NPI 1215375373) is an individual diagnostic radiology provider in Dallas, Texas, licensed in Massachusetts (1018091) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Adventist Health Castle, and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1215375373
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. RUSSELL PHELPS KELLEY IVCredential: M.D.
Location Address2825 OAK LAWN AVE UNIT 192749Dallas, TX 75219-4688
Mailing Address2825 Oak Lawn Ave Unit 192749Dallas, TX 75219-4688 · (510) 683-9500 · Fax (877) 880-2039
Phone(510) 689-9500
Fax(877) 880-2039
Sole ProprietorNo
Medical School CMSHarvard Medical SchoolGraduated 2013
Enumeration DateJune 11, 2013
Last NPPES UpdateDecember 20, 20244 updates tracked since enumeration
NPPES CertifiedDecember 20, 2024
✔ NPI 1215375373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses✔ Licensed in MA · 1018091✔ Licensed in TX · S3004✔ Licensed in CA · A135999✔ Licensed in NC · 2024-03651
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
2825 OAK LAWN AVE UNIT 192749, Dallas, TX 75219
Open in Google Maps ↗

Secondary Practice Location 1

Location 175 Francis StBoston, MA 02115-6110 · Phone (617) 732-5500

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

Dr. Russell Phelps Kelley Iv 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 ID749416519
PECOS Enrollment IDI20240711000521
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

6

Medicare enrollment records show Russell Kelley reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Blue Ridge Healthcare Medical Group Inc
889 mi
Diagnostic Radiology
2201 S. STERLING STREET
Morganton, NC 28655
  • Reassigned Medicare billing, Massachusetts enrollment
  • 3 clinicians in this Medicare group
NPI 1639244478 (828) 580-6900
Sutter Valley Medical Foundation
1,080 mi
Diagnostic Radiology
2995 AMERICAN RIVER LN
Las Vegas, NV 89135
  • Reassigned Medicare billing, Massachusetts enrollment
  • 5 clinicians in this Medicare group
NPI 1174997407 (209) 521-6097
St Agnes Healthcare Inc
1,209 mi
Diagnostic Radiology
3449 WILKENS AVE, SUITE 102
Baltimore, MD 21229
  • Reassigned Medicare billing, Massachusetts enrollment
  • 4 clinicians in this Medicare group
NPI 1780615922 (667) 234-8675
Stanford Health Care
1,467 mi
General Acute Care Hospital
300 PASTEUR DRIVE
Stanford, CA 94305
  • Reassigned Medicare billing, Massachusetts enrollment
  • 3 clinicians in this Medicare group
NPI 1437292927 (650) 723-4000
University Of California Sfgh Medical Group
1,481 mi
Diagnostic Radiology
1001 POTRERO AVENUE BLDG 5, 1ST FL
San Francisco, CA 94110
  • Reassigned Medicare billing, California enrollment
  • 336 clinicians in this Medicare group
NPI 1063487122 (628) 206-5871
Pacific Radiology Group Inc
3,794 mi
Specialist
347 KUAKINI ST
Honolulu, HI 96817
  • Reassigned Medicare billing, Massachusetts enrollment
  • 3 clinicians in this Medicare group
NPI 1871577536 (808) 522-0190

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventist Health Castle

Acute Care Hospitals · Kailua, HI
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number120006
Location640 Ulukahiki StKailua, HI 96734 · Honolulu County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75219 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
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 20

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

AJLA KADRIBEGIC MD
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
DR. MATTHEW AARON HABER M.D.
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
IAN PAN MD
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
SE JIN AHN M.D.
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
DR. TU THAO HAM PHAM M.D.
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (844) 389-5711
DR. SEJAL SHAH M.D.
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
CONNOR CORNELIS GEMMELL BYRNE MD
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (510) 683-9500
YVONNE CESENA MORENO MD
Radiology (Diagnostic Radiology)
2825 OAK LAWN AVE UNIT 192749
DALLAS, TX 75219
Dallas County (844) 389-5711

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 Russell Kelley's NPI number?

The NPI number for Russell Kelley is 1215375373. It was assigned to this individual provider in the NPPES registry on June 11, 2013.

Where is Russell Kelley located?

Russell Kelley practices at 2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219. The listed phone number is (510) 689-9500.

What is Russell Kelley's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Russell Kelley enrolled in Medicare?

Yes. Russell 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 Russell Kelley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Russell Kelley reassigns Medicare benefits to 6 organizations: Blue Ridge Healthcare Medical Group Inc (Morganton, NC), Sutter Valley Medical Foundation (Las Vegas, NV), St Agnes Healthcare Inc (Baltimore, MD), Stanford Health Care (Stanford, CA), University Of California Sfgh Medical Group (San Francisco, CA) and 1 more organization, listed in the Medicare section above. 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 Russell Kelley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Russell Kelley affiliated with any hospitals?

According to CMS data, Russell Kelley is affiliated with Adventist Health Castle.

When was this NPI record last updated?

The NPPES record for Russell Kelley was last updated on December 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.