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RANDALL JAMES KELLEY D.M.D.
NPI 1538387154
Dentist - General Practice in Provo, UT

Active since April 20, 2007PECOS Enrolled
275 N 500 W, SUITE C, PROVO, UT 84601(801) 374-5768(801) 375-3598 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randall James Kelley D.m.d. NPPES

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

RANDALL JAMES KELLEY D.M.D. (NPI 1538387154) is an individual general practice provider in Provo, Utah, licensed in California (33052) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538387154
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameRANDALL JAMES KELLEYCredential: D.M.D.
Location Address275 N 500 W, SUITE CProvo, UT 84601-3006
Mailing Address9255 Maison DrSandy, UT 84093-2427 · (650) 218-0069 · Fax (801) 375-3598
Phone(801) 374-5768
Fax(801) 375-3598
Sole ProprietorNo
Enumeration DateApril 20, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1538387154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 33052
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
275 N 500 W, Provo, UT 84601
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randall James Kelley D.m.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84601 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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

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

JEFFREY A. THOMAS DDS
Dentist (General Practice)
275 N 500 W
PROVO, UT 84601
Utah County (801) 374-5768

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 Randall Kelley's NPI number?

The NPI number for Randall Kelley is 1538387154. It was assigned to this individual provider in the NPPES registry on April 20, 2007.

Where is Randall Kelley located?

Randall Kelley practices at 275 N 500 W Suite C, Provo, UT 84601. The listed phone number is (801) 374-5768.

What is Randall Kelley's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Randall Kelley enrolled in Medicare?

Yes. Randall Kelley is registered in the Medicare PECOS enrollment system.

What insurance does Randall Kelley accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BridgeSpan Health Company and 12 other insurers list Randall Kelley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Randall Kelley was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.