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SEAN KELLY PA-C
NPI 1285170738
Physician Assistant in Traverse City, MI

Active since January 09, 2017PECOS EnrolledAccepts Medicare Assignment
1105 6TH ST, TRAVERSE CITY, MI 49684(231) 947-0673(801) 740-2847 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 29, 2021, Jan 9, 2017 (2 updates tracked since 2017).

About Sean Kelly Pa-c NPPES

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

SEAN KELLY PA-C (NPI 1285170738) is an individual physician assistant in Traverse City, Michigan, licensed in Michigan (5601008056) and active in the NPI registry since January 2017. He is enrolled in Medicare PECOS, is affiliated with Covenant Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1285170738
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSEAN KELLYCredential: PA-C
Location Address1105 6TH STTraverse City, MI 49684-2349
Mailing Address4624 N Spider Lake RdTraverse City, MI 49696-8440 · (231) 947-0673 · Fax (801) 740-2847
Phone(231) 947-0673
Fax(801) 740-2847
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJanuary 9, 2017
Last NPPES UpdateMarch 29, 20212 updates tracked since enumeration
NPPES CertifiedMarch 29, 2021
✔ NPI 1285170738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601008056
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1105 6TH ST, Traverse City, MI 49684
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Other Identifiers 1

Other5601008056MI · License

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

Sean Kelly Pa-c 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 ID840573754
PECOS Enrollment IDI20170220000091
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.

Areas of Expertise CMS Part B claims 4

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
155 services149 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
33 services33 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
23 services23 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.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Covenant Medical Center

Acute Care Hospitals · Saginaw, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230070
Location1447 N HarrisonSaginaw, MI 48602 · Saginaw County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 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.

ADVANCED WOUND CARE & HYPERBARIC PHYSICIANS OF TRAVERSE CITY, PLC
Emergency Medicine
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 947-0673
BEVIN CLAYTON DO
Emergency Medicine
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 947-0673
TRAVERSE ANESTHESIA ASSOCIATES, PC
Anesthesiology (Pain Medicine)
1105 6TH ST, MUNSON MEDICAL CENTER/TRAVERSE ANESTHESIA ASSOCIATES, P
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-5770
MR. DONALD EDWARD ROUTZAHN RPH
Pharmacist
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-5000
DR. PHILIP MICHAEL DIMONDO PHARMD
Pharmacist
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-6559
NATALIE C CREW RD
Dietitian, Registered
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-6447
KARLA A FISHBURN RN
Registered Nurse
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-3321
DALE C BLUM M.D.
Emergency Medicine (Emergency Medical Services)
1105 6TH ST
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 947-0673

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 Sean Kelly's NPI number?

The NPI number for Sean Kelly is 1285170738. It was assigned to this individual provider in the NPPES registry on January 9, 2017.

Where is Sean Kelly located?

Sean Kelly practices at 1105 6th St, Traverse City, MI 49684. The listed phone number is (231) 947-0673.

What is Sean Kelly's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Sean Kelly enrolled in Medicare?

Yes. Sean 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.

Is Sean Kelly affiliated with any hospitals?

According to CMS data, Sean Kelly is affiliated with Covenant Medical Center.

When was this NPI record last updated?

The NPPES record for Sean Kelly was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.