GRETCHEN LOUISE KELLEY M.D.
NPI 1376539346
Family Medicine in Baldwinville, MA

Q: What is Gretchen Kelley's NPI number?

The NPI number for Gretchen Kelley is 1376539346. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Q: What is Gretchen Kelley's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gretchen Kelley was last updated on April 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

570 BALDWINVILLE RD, BALDWINVILLE, MA 01436(978) 939-2133(978) 939-8580 Get Directions Write a Review

NPPES record last updated: April 5, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Gretchen Louise Kelley M.d. NPPES

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

GRETCHEN LOUISE KELLEY M.D. (NPI 1376539346) is an individual family medicine provider in Baldwinville, Massachusetts, licensed in Massachusetts (80406) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Massachusetts Medical School (1993).

NPPES Registry Identity

NPI1376539346

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameGRETCHEN LOUISE KELLEYCredential: M.D.

Location Address570 BALDWINVILLE RDBaldwinville, MA 01436-1351

Mailing Address570 Baldwinville RdBaldwinville, MA 01436-1351 · (978) 939-2133 · Fax (978) 939-8580

Phone(978) 939-2133

Fax(978) 939-8580

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 1993

Enumeration DateSeptember 23, 2005

Last NPPES UpdateApril 5, 2010

✔ NPI 1376539346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MA · 80406

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

570 BALDWINVILLE RD, Baldwinville, MA 01436

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Other Identifiers 3

Medicare ID-Type UnspecifiedA21197MA

Medicare UPING26256

Medicaid3138879MA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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

Gretchen Louise Kelley 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 ID3870654502

PECOS Enrollment IDI20081212000356

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 14

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

333 services203 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

182 services177 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

157 services139 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

106 services74 patients

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.

57 services51 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

53 services53 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

48 services48 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

34 services30 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

21 services20 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

15 services15 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

12 services12 patients

Removal of impacted ear wax by washing 69209

Impacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.

11 services11 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296

This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220001

Location60 Hospital RoadLeominster, MA 01453 · Worcester County

Emergency services

Heywood Hospital

Acute Care Hospitals · Gardner, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220095

Location242 Green StreetGardner, MA 01440 · Worcester County

Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Athol Memorial Hospital

Critical Access Hospitals · Athol, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number221303

Location2033 Main StreetAthol, MA 01331 · Worcester County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01436 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

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.09

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

79%5,602 patients3/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

100%30 patients5/55-star benchmark: 96%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

94%1,964 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

82%1,346 patients4/55-star benchmark: 99%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

61%1,346 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

6%1,346 patients1/55-star benchmark: 59%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers29 claims64 services$5.87 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers21 claims21 services$1.08 avg. paid by Medicare

Male external catheter, with or without adhesive, disposable, each A4349

DME-Medical/Surgical Supplies · category DA000N

1 supplier12 claims405 services$1.63 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier12 claims24 services$6.63 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

1 supplier12 claims24 services$5.33 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers11 claims11 services$32.62 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers12 claims12 services$75.99 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers12 claims34 services$27.52 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers11 claims11 services$16.10 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers21 claims110 services$1.90 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

3 suppliers11 claims11 services$10.66 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers12 claims358 services$4.37 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

2 suppliers23 claims10,351 services$0.26 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier34 claims36 services$12.84 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier33 claims35 services$58.26 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$35.04 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

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

KELLY E HOISINGTON D.O.

Family Medicine