KELLY OWEN
NPI 1255082673
Nurse Practitioner - Acute Care in Riverside, CA

Q: What is Kelly Owen's NPI number?

The NPI number for Kelly Owen is 1255082673. It was assigned to this individual provider in the NPPES registry on January 17, 2022.

Q: What is Kelly Owen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Owen was last updated on June 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 January 17, 2022PECOS EnrolledAccepts Medicare Assignment

4646 BROCKTON AVE STE 203, RIVERSIDE, CA 92506(951) 394-7028 Get Directions Write a Review

NPPES record last updated: June 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 5, 2023, Jan 17, 2022 (2 updates tracked since 2022).

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About Kelly Owen NPPES

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

KELLY OWEN (NPI 1255082673) is an individual acute care provider in Riverside, California, licensed in California (NP95019278) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1255082673

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameKELLY OWEN

Location Address4646 BROCKTON AVE STE 203Riverside, CA 92506-0104

Mailing Address4646 Brockton Ave Ste 203Riverside, CA 92506-0104 · (951) 394-7028

Phone(951) 394-7028

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 17, 2022

Last NPPES UpdateJune 5, 20232 updates tracked since enumeration

NPPES CertifiedJune 5, 2023

✔ NPI 1255082673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in CA · NP95019278

4646 BROCKTON AVE STE 203, Riverside, CA 92506

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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 Owen 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 ID2163800772

PECOS Enrollment IDI20220609000588

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92506 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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 6

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

ORANGECREST MEDICAL GROUP, INC.

Family Medicine