BRIAN ISMAEL KELLY NP
NPI 1407649957
Nurse Practitioner in Stockton, CA
About Brian Ismael Kelly Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRIAN ISMAEL KELLY NP (NPI 1407649957) is an individual nurse practitioner in Stockton, California, licensed in California (95184031) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brian Ismael Kelly Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Brian Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Redding, CA 96001
- Reassigned Medicare billing, California enrollment
- 63 clinicians in this Medicare group
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 95203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Brian Kelly's NPI number?
The NPI number for Brian Kelly is 1407649957. It was assigned to this individual provider in the NPPES registry on May 27, 2025.
Where is Brian Kelly located?
Brian Kelly practices at 525 W Acacia St, Stockton, CA 95203. The listed phone number is (209) 944-5550.
What is Brian Kelly's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Brian Kelly enrolled in Medicare?
Yes. Brian Kelly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Brian Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brian Kelly reassigns Medicare benefits to Trinity Emergency Physicians (Redding, CA). 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 Brian 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 Brian Kelly was last updated on July 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Brian Ismael Kelly, NP · NPI 1407649957
Nurse Practitioner physician in Stockton, California. Individual provider, active in the CMS NPPES registry since May 27, 2025.
## Identity
- **NPI:** 1407649957 (Entity type: Individual)
- **Enumerated:** May 27, 2025
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 95184031 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 525 W ACACIA ST, Stockton, CA 95203-2405
- **Phone:** (209) 944-5550
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Trinity Emergency Physicians (NPI 1508605635, Redding, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 26, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1407649957) · Data from the CMS NPPES public registry.