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MICHAEL C KELLY D.M.D
NPI 1265888655
Dentist in Chicago, IL

Active since May 04, 2016PECOS Enrolled
5425 W LAKE ST, CHICAGO, IL 60644(773) 378-3347 Get Directions Write a Review

NPPES record last updated: December 24, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 24, 2019, May 11, 2016 (2 updates tracked since 2016).

About Michael C Kelly D.m.d NPPES

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

MICHAEL C KELLY D.M.D (NPI 1265888655) is an individual dentist in Chicago, Illinois, licensed in Illinois (19030568) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1265888655
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMICHAEL C KELLYCredential: D.M.D
Location Address5425 W LAKE STChicago, IL 60644-2342
Mailing Address568 S Spring Rd, Ste AElmhurst, IL 60126-3868
Phone(773) 378-3347
Sole ProprietorYes
Enumeration DateMay 4, 2016
Last NPPES UpdateDecember 24, 20192 updates tracked since enumeration
✔ NPI 1265888655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 19030568
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
5425 W LAKE ST, Chicago, IL 60644
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1568 S Spring Rd, Ste AElmhurst, IL 60126-3868 · Phone (630) 833-5007
Location 26201 Roosevelt RdBerwyn, IL 60402-1108 · Phone (708) 386-0845

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael C Kelly D.m.d 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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pcc Community Wellness Center
0.7 mi
Federally Qualified Health Center (FQHC)
14 LAKE ST
Oak Park, IL 60302
  • Reassigned Medicare billing, Illinois enrollment
  • 221 clinicians in this Medicare group
NPI 1871516799 (708) 383-0113

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60644 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.

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.

DR. GABRIELLE DENISE GAY MD
Family Medicine
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
MICHELLE BEHRENS
Social Worker (Clinical)
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
ALVIE BENDER LCSW
Social Worker (Clinical)
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
PETER M CHAPMAN LCSW
Social Worker (Clinical)
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
DR. SWETA SHAH DDS
Dentist (General Practice)
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
CHRISTINE SWARTZ MD
Family Medicine
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347
PCC COMMUNITY WELLNESS CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 413-1920
EMILY A LOVAASEN MD
Family Medicine
5425 W LAKE ST
CHICAGO, IL 60644
Cook County (773) 378-3347

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 Michael Kelly's NPI number?

The NPI number for Michael Kelly is 1265888655. It was assigned to this individual provider in the NPPES registry on May 4, 2016.

Where is Michael Kelly located?

Michael Kelly practices at 5425 W Lake St, Chicago, IL 60644. The listed phone number is (773) 378-3347.

What is Michael Kelly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Michael Kelly enrolled in Medicare?

Yes. Michael Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michael Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Kelly reassigns Medicare benefits to Pcc Community Wellness Center (Oak Park, IL). The 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 Michael Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Kelly was last updated on December 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.