Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. SAMUEL KELLY MD
NPI 1265991442
Internal Medicine - Cardiovascular Disease in Philadelphia, PA

Q: What is Samuel Kelly's NPI number?

The NPI number for Samuel Kelly is 1265991442. It was assigned to this individual provider in the NPPES registry on March 18, 2019.

Q: What is Samuel Kelly's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Kelly was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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 March 18, 2019PECOS Enrolled

1101 CHESTNUT ST FL 9, PHILADELPHIA, PA 19107(215) 955-5050(215) 955-5050 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 27, 2026, Jul 14, 2022, Mar 18, 2019 (3 updates tracked since 2019).

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About Dr. Samuel Kelly Md NPPES

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

DR. SAMUEL KELLY MD (NPI 1265991442) is an individual cardiovascular disease provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD494843) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265991442

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. SAMUEL KELLYCredential: MD

Location Address1101 CHESTNUT ST FL 9Philadelphia, PA 19107-3612

Mailing Address1101 Chestnut St Fl 9Philadelphia, PA 19107-3612 · (215) 955-5050

Phone(215) 955-5050

Fax(215) 955-5050

Sole ProprietorNo

Enumeration DateMarch 18, 2019

Last NPPES UpdateAugust 27, 20263 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

✔ NPI 1265991442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in PA · MD494843

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1101 CHESTNUT ST FL 9, Philadelphia, PA 19107

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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 (PECOS)

Dr. Samuel Kelly Md 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19107 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

$137.17 typical visit price

range $59.88 – $180.99

Typical copayment $34.29 (range $14.97 – $45.24)

Most-billed visit code 99204

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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 11

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

HANS FRIEDRICH STABENAU M.D., PH.D.

Internal Medicine (Clinical Cardiac Electrophysiology)