1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Nurse Practitioner
  6. NPI Profile

ANNETTE L KELLEHER NP
NPI 1316178676
Nurse Practitioner - Gerontology in Providence, RI

Active since August 05, 2009PECOS Enrolled
50 MAUDE ST, PROVIDENCE, RI 02908(401) 456-6616(401) 456-6780 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Annette L Kelleher Np NPPES

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

ANNETTE L KELLEHER NP (NPI 1316178676) is an individual gerontology provider in Providence, Rhode Island, licensed in Rhode Island (NPP37519) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316178676
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameANNETTE L KELLEHERCredential: NP
Location Address50 MAUDE STProvidence, RI 02908-4325
Mailing Address9201 E Mountain View Rd Ste 220Scottsdale, AZ 85258-5172 · (855) 246-6287
Phone(401) 456-6616
Fax(401) 456-6780
Sole ProprietorYes
Enumeration DateAugust 5, 2009
Last NPPES UpdateJuly 17, 2019
✔ NPI 1316178676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in RI · NPP37519
50 MAUDE ST, Providence, RI 02908
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Annette L Kelleher Np 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 Annette Kelleher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Matrix Medical Plus
912 mi
Nurse Practitioner
424 CHURCH ST STE 2600
Nashville, TN 37219
  • Reassigned Medicare billing, Massachusetts enrollment
  • 125 clinicians in this Medicare group
NPI 1376973461 (877) 564-3627

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 02908 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
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.

ROGER WILLIAMS RADIATION THERAPY, LLC
Radiology (Radiation Oncology)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2690
DANIEL N VALICENTI MD
Internal Medicine
50 MAUDE ST, 4TH FLOOR
PROVIDENCE, RI 02908
Providence County (401) 456-5300
MOHAMMAD ABDALLAT MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2077
NEW UNIVERSITY MEDICAL GROUP LLC
Internal Medicine
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2525
ROGER WILLIAMS MEDICAL CENTER
Home Health
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2273
ELINA GOMAN BASKIN O.D.
Optometrist
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 351-5664
RABIH EL-BIZRI MD
Internal Medicine (Pulmonary Disease)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-5714
ELMHURST EXTENDED CARE FACILITIES, INC.
Skilled Nursing Facility
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2623

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 Annette Kelleher's NPI number?

The NPI number for Annette Kelleher is 1316178676. It was assigned to this individual provider in the NPPES registry on August 5, 2009.

Where is Annette Kelleher located?

Annette Kelleher practices at 50 Maude St, Providence, RI 02908. The listed phone number is (401) 456-6616.

What is Annette Kelleher's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Annette Kelleher enrolled in Medicare?

Yes. Annette Kelleher is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Annette Kelleher's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Annette Kelleher reassigns Medicare benefits to Matrix Medical Plus (Nashville, TN). 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 Annette Kelleher'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 Annette Kelleher was last updated on July 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.