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DR. TERESA GROSS KELLY M.D
NPI 1275580672
Radiology - Diagnostic Radiology in Grand Rapids, MI

Active since May 30, 2006PECOS EnrolledAccepts Medicare Assignment
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 363-7272(616) 361-5828 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Teresa Gross Kelly M.d NPPES

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

DR. TERESA GROSS KELLY M.D (NPI 1275580672) is an individual diagnostic radiology provider in Grand Rapids, Michigan, licensed in Michigan (4301052060) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1275580672
Entity TypeIndividualFemale
Primary Taxonomy2085R0202X
Provider Legal NameDR. TERESA GROSS KELLYCredential: M.D
Location Address3264 N EVERGREEN DR NEGrand Rapids, MI 49525-9746
Mailing Address3264 N Evergreen Dr NeGrand Rapids, MI 49525-9746 · (616) 363-7272 · Fax (616) 361-5828
Phone(616) 363-7272
Fax(616) 361-5828
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 1987
Enumeration DateMay 30, 2006
Last NPPES UpdateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1275580672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in MI · 4301052060
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Also ListedRadiology · Pediatric RadiologyTaxonomy 2085P0229X · License 52993 (WI), ME70684 (FL)
3264 N EVERGREEN DR NE, Grand Rapids, MI 49525
Open in Google Maps ↗

Other Names 1

Former Name (1)Teresa Kelly

Secondary Practice Locations 2

Location 19000 W Wisconsin Ave, PEDIATRIC RADIOLOGYMilwaukee, WI 53226-4874 · Phone (414) 266-1686
Location 29200 W Wisconsin AveMilwaukee, WI 53226-3522 · Phone (414) 805-2060 · Fax (414) 259-9290

Other Identifiers 2

Medicaid1275580672WI
Medicaid250150300FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Teresa Gross Kelly M.d 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 ID7012939341
PECOS Enrollment IDI20090625000439
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 Reassignments

4

Medicare enrollment records show Teresa Kelly reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advanced Radiology Services PC
0.2 mi
Diagnostic Radiology
3264 N EVERGREEN DR NE
Grand Rapids, MI 49525
  • Reassigned Medicare billing, Michigan and Wisconsin enrollments
  • 228 clinicians in this Medicare group
NPI 1740283324 (616) 363-7272
The Medical College Of Wisconsin, Inc.
123 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101
Children's Specialty Group, Inc.
123 mi
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
Froedtert & the Medical College Of Wisconsin Community Physicians, Inc.
129 mi
Internal Medicine
W180N8000 TOWN HALL RD
Menomonee Falls, WI 53051
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,294 clinicians in this Medicare group
NPI 1568787448 (262) 255-2500

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
18 services18 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
14 services14 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230017
Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County
Emergency services Birthing friendly

Lakeland Hospital, St Joseph

Acute Care Hospitals · St Joseph, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230021
Location1234 Napier AvenueSt Joseph, MI 49085 · Berrien County
Emergency services Birthing friendly

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number230075
Location300 North AvenueBattle Creek, MI 49017 · Calhoun County
Emergency services Birthing friendly

Mymichigan Medical Center Midland

Acute Care Hospitals · Midland, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230222
Location4000 Wellness DriveMidland, MI 48670 · Midland County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49525 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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. JON R HENKE MD
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7272
GEOFFREY M. REMES M.D.
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7339
JAN L MOURELATOS M.D.
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7272
DR. BRENDAN MICHAEL BANYON M.D.
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7272
BRYANT THOMAS WILSON PA-C
Physician Assistant
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7339
DR. JOSEPH J JUNEWICK MD
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7272
KEITH ALAN MORROW D.O.
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7339
DR. ANDREW KENT MORIARITY M.D.
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-7339

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 Teresa Kelly's NPI number?

The NPI number for Teresa Kelly is 1275580672. It was assigned to this individual provider in the NPPES registry on May 30, 2006.

Where is Teresa Kelly located?

Teresa Kelly practices at 3264 N Evergreen Dr NE, Grand Rapids, MI 49525. The listed phone number is (616) 363-7272.

What is Teresa Kelly's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Teresa Kelly enrolled in Medicare?

Yes. Teresa Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Teresa Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Teresa Kelly reassigns Medicare benefits to 4 organizations: Advanced Radiology Services PC (Grand Rapids, MI), The Medical College Of Wisconsin, Inc. (Milwaukee, WI), Children's Specialty Group, Inc. (Milwaukee, WI) and Froedtert & the Medical College Of Wisconsin Community Physicians, Inc. (Menomonee Falls, WI). Each 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 Teresa Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Teresa Kelly affiliated with any hospitals?

According to CMS data, Teresa Kelly is affiliated with Bronson Methodist Hospital, Lakeland Hospital, St Joseph, Spectrum Health, Bronson Battle Creek Hospital and Mymichigan Medical Center Midland.

When was this NPI record last updated?

The NPPES record for Teresa Kelly was last updated on November 26, 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.