KELLY CODERRE
NPI 1235601113
Physician Assistant in Chicago, IL

Q: What is Kelly Coderre's NPI number?

The NPI number for Kelly Coderre is 1235601113. It was assigned to this individual provider in the NPPES registry on December 17, 2018.

Q: What is Kelly Coderre's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Coderre was last updated on December 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 December 17, 2018PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1500 S FAIRFIELD AVE, CHICAGO, IL 60608(773) 542-2000 Get Directions Write a Review

NPPES record last updated: December 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kelly Coderre NPPES

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

KELLY CODERRE (NPI 1235601113) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085.006717) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS, is affiliated with Osf Little Company Of Mary Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1235601113

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY CODERRE

Location Address1500 S FAIRFIELD AVEChicago, IL 60608-1782

Mailing Address820 Bruce AveFlossmoor, IL 60422-1250 · (708) 612-6036

Phone(773) 542-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateDecember 17, 2018

✔ NPI 1235601113 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 IL · 085.006717

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.

1500 S FAIRFIELD AVE, Chicago, IL 60608

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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 Coderre 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 ID4688911902

PECOS Enrollment IDI20190124002229

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 4

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 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.

36 services36 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

13 services13 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Osf Little Company Of Mary Medical Center

Acute Care Hospitals · Evergreen Park, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140179

Location2800 W 95th StEvergreen Park, IL 60805 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60608 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

94.69

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.

AUDREY SHAE WHITNAH

Pharmacist