STEPHEN KELLY PA-C
NPI 1235781584
Physician Assistant - Medical in Tacoma, WA
About Stephen Kelly Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHEN KELLY PA-C (NPI 1235781584) is an individual medical provider in Tacoma, Washington, licensed in Washington (61188032) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Providence Centralia Hospital, and is a graduate of University Of Utah School Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stephen Kelly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Providence Centralia Hospital
Acute Care Hospitals · Centralia, WAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TACOMA, WA 98431
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 Stephen Kelly's NPI number?
The NPI number for Stephen Kelly is 1235781584. It was assigned to this individual provider in the NPPES registry on July 16, 2019.
Where is Stephen Kelly located?
Stephen Kelly practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (609) 774-4071.
What is Stephen Kelly's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Stephen Kelly enrolled in Medicare?
Yes. Stephen Kelly is registered in the Medicare PECOS enrollment system.
Is Stephen Kelly affiliated with any hospitals?
According to CMS data, Stephen Kelly is affiliated with Providence Centralia Hospital.
When was this NPI record last updated?
The NPPES record for Stephen Kelly was last updated on November 13, 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.
# Stephen Kelly, PA-C · NPI 1235781584
Medical physician in Tacoma, Washington. Individual provider, active in the CMS NPPES registry since July 16, 2019.
## Identity
- **NPI:** 1235781584 (Entity type: Individual)
- **Enumerated:** July 16, 2019
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 61188032 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 9040 JACKSON AVE, Tacoma, WA 98431-5086
- **Phone:** (609) 774-4071
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Utah School Of Medicine, class of 2020
## Record status
- **NPPES last updated:** November 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1235781584) · Data from the CMS NPPES public registry.