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KELLY OTP LLC
NPI 1265150767
Clinic/Center - Methadone in Roseville, MI

Active since August 19, 2022
25200 KELLY RD, ROSEVILLE, MI 48066(586) 422-1250 Get Directions Write a Review

NPPES record last updated: August 16, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 16, 2023, Oct 12, 2022, Sep 29, 2022 and 1 more (4 updates tracked since 2022).

About Kelly Otp Llc NPPES

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

KELLY OTP LLC (NPI 1265150767) is a healthcare organization registered as a methadone in Roseville, Michigan and active in the NPI registry since August 2022. The organization lists Aaron Douglas Alston, Pratice Administrator, as its authorized official.

NPPES Registry Identity

NPI1265150767
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameKELLY OTP LLC
Location Address25200 KELLY RDRoseville, MI 48066-4473
Mailing Address7 Riverbank DrBeverly Hills, MI 48025-4800 · (248) 971-0150
Phone(586) 422-1250
Organization SubpartNo
Authorized OfficialAaron Douglas AlstonPratice Administrator · (248) 971-0150
Enumeration DateAugust 19, 2022
Last NPPES UpdateAugust 16, 20234 updates tracked since enumeration
NPPES CertifiedAugust 16, 2023
✔ NPI 1265150767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedPsychologist · CounselingTaxonomy 103TC1900X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X
25200 KELLY RD, Roseville, MI 48066
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Otp Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Kelly Otp LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Amanda Pierce, LMSW
Clinical Social Worker
NPI 1588826556
13213 E 14 MILE RD
Sterling Heights, MI 48312
(586) 939-4374
✔ PECOS✔ Accepts Medicare5.2 mi
Jason Peter, D.O.
Interventional Pain Management
NPI 1851581789
2885 E LONG LAKE RD STE A
Troy, MI 48085
(248) 266-9137
✔ PECOS✔ Accepts Medicare11 mi
Randy Pierce
General Practice
NPI 1578981932
7443 JACKMAN RD
Temperance, MI 48182
(734) 850-0100
✔ PECOS60 mi
James Shirley, M.D
Diagnostic Radiology
NPI 1427176429
9958 PENINSULA DR
Traverse City, MI 49686
(231) 421-5722
✔ PECOS✔ Accepts Medicare209 mi

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

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 Kelly Otp LLC's NPI number?

The NPI number for Kelly Otp LLC is 1265150767. It was assigned to this organization in the NPPES registry on August 19, 2022.

Where is Kelly Otp LLC located?

Kelly Otp LLC is located at 25200 Kelly Rd, Roseville, MI 48066. The listed phone number is (586) 422-1250.

What is Kelly Otp LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Is Kelly Otp LLC enrolled in Medicare?

Yes. Kelly Otp LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kelly Otp LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Kelly Otp LLC, in Clinical Social Worker, Diagnostic Radiology, General Practice and Interventional Pain Management. A 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 the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kelly Otp LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Kelly Otp LLC 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 Kelly Otp LLC was last updated on August 16, 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.