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JACQUELINE RITA KELLY CRNP
NPI 1366203036
Nurse Practitioner - Pediatrics in Baltimore, MD

Active since January 19, 2024PECOS Enrolled
737 W LOMBARD ST, BALTIMORE, MD 21201(410) 706-2300(410) 706-5770 Get Directions Write a Review

NPPES record last updated: January 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacqueline Rita Kelly Crnp NPPES

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

JACQUELINE RITA KELLY CRNP (NPI 1366203036) is an individual pediatrics provider in Baltimore, Maryland, licensed in Maryland (R236041) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1366203036
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameJACQUELINE RITA KELLYCredential: CRNP
Location Address737 W LOMBARD STBaltimore, MD 21201-1009
Mailing Address140 Marie CirAston, PA 19014-2268 · (610) 804-4656
Phone(410) 706-2300
Fax(410) 706-5770
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJanuary 19, 2024
NPPES CertifiedJanuary 19, 2024
✔ NPI 1366203036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MD · R236041
737 W LOMBARD ST, Baltimore, MD 21201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Rita Kelly Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911346085
PECOS Enrollment IDI20260610002049
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

2

Medicare enrollment records show Jacqueline Kelly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Maryland Pediatric Associates, PA
0.1 mi
Clinical Medical Laboratory
120 SOUTH PENN STREET
Baltimore, MD 21201
  • Reassigned Medicare billing, Maryland enrollment
  • 172 clinicians in this Medicare group
NPI 1679685804 (410) 706-5181
Lighthouse Complex Care Of Delaware Inc
70 mi
Multi-Specialty
2500 GRUBB RD STE 123
Wilmington, DE 19810
  • Reassigned Medicare billing, Delaware enrollment
  • 6 clinicians in this Medicare group
NPI 1720797251 (302) 304-3417

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 21201 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
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

KRISTYN DONOHUE PH.D.
Psychologist
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 328-0679
STEPHANIE ALLISON KORENIC
Student in an Organized Health Care Education/Training Program
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 706-0980
YIFEI LIN SCM
Genetic Counselor, MS
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 328-3335
JENNIFER GARTH
Genetic Counselor, MS
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 328-3335
ELIZABETH CONNORS PHD
Psychologist (Clinical Child & Adolescent)
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 706-1456
NIA S CALDWELL LMSW
Student in an Organized Health Care Education/Training Program
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 706-6895
ASIA HUMPHRIES LMSW
Student in an Organized Health Care Education/Training Program
737 W LOMBARD ST
BALTIMORE, MD 21201
Baltimore City (410) 706-6895
RACHEL NINA PALMQUIST M.S.
Genetic Counselor, MS
737 W LOMBARD ST, SUITE 196
BALTIMORE, MD 21201
Baltimore City (410) 328-3335

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 Jacqueline Kelly's NPI number?

The NPI number for Jacqueline Kelly is 1366203036. It was assigned to this individual provider in the NPPES registry on January 19, 2024.

Where is Jacqueline Kelly located?

Jacqueline Kelly practices at 737 W Lombard St, Baltimore, MD 21201. The listed phone number is (410) 706-2300.

What is Jacqueline Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Jacqueline Kelly enrolled in Medicare?

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

Which organizations bill Medicare for Jacqueline Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Kelly reassigns Medicare benefits to 2 organizations: University Of Maryland Pediatric Associates, PA (Baltimore, MD) and Lighthouse Complex Care Of Delaware Inc (Wilmington, DE). 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 Jacqueline 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 Jacqueline Kelly was last updated on January 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.