STEPHEN KELLY PA-C
NPI 1235781584
Physician Assistant - Medical in Tacoma, WA

Active since July 16, 2019PECOS Enrolled
9040 JACKSON AVE, TACOMA, WA 98431(609) 774-4071 Get Directions Write a Review

NPPES record last updated: November 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 13, 2024, Jan 2, 2024, May 31, 2021 and 1 more (4 updates tracked since 2019).

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.

NPPES Registry Identity

NPI1235781584
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSTEPHEN KELLYCredential: PA-C
Location Address9040 JACKSON AVETacoma, WA 98431-5086
Mailing Address9315 Windsor Ln Ne # A202Olympia, WA 98516-5953 · (609) 774-4071
Sole ProprietorNo
Enumeration DateJuly 16, 2019
Last NPPES UpdateNovember 13, 20244 updates tracked since enumeration
NPPES CertifiedNovember 13, 2024
✔ NPI 1235781584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in WA · 61188032
9040 JACKSON AVE, Tacoma, WA 98431

Accepted Insurance

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).

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.

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.

Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Psychologist (Clinical)
9040 JACKSON AVE
TACOMA, WA 98431
Physical Therapist
9040 JACKSON AVE
TACOMA, WA 98431
Anesthesiology
9040 JACKSON AVE
TACOMA, WA 98431
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
General Practice
9040 JACKSON AVE
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.

What insurance does Stephen Kelly accept?

Health plans from Providence Health Plan list Stephen Kelly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 23 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.