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DR. JOHN J KELLY DDS
NPI 1619171121
Dentist in Chicago, IL

Active since June 11, 2007PECOS Enrolled
5350 W DEVON AVENUE, CHICAGO, IL 60646(773) 631-6844(773) 631-7438 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. John J Kelly Dds NPPES

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

DR. JOHN J KELLY DDS (NPI 1619171121) is an individual dentist in Chicago, Illinois and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619171121
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JOHN J KELLYCredential: DDS
Location Address5350 W DEVON AVENUEChicago, IL 60646-4143
Mailing Address5350 W Devon AvenueChicago, IL 60646-4143 · (773) 631-6844 · Fax (773) 631-7438
Phone(773) 631-6844
Fax(773) 631-7438
Sole ProprietorNo
Enumeration DateJune 11, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1619171121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
5350 W DEVON AVENUE, Chicago, IL 60646
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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)

Dr. John J Kelly Dds 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 Reassignments

2

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

Head & Neck Cosmetic Surgery Associates LLC
3.2 mi
Otolaryngology
8930 GROSS POINT RD STE 700
Skokie, IL 60077
  • Reassigned Medicare billing, Illinois enrollment
  • 31 clinicians in this Medicare group
NPI 1558330811 (773) 262-4110
Specialty Care Institute, PLLC
30 mi
Specialist
1750 N RANDALL RD STE 210
Elgin, IL 60123
  • Reassigned Medicare billing, Illinois enrollment
  • 18 clinicians in this Medicare group
NPI 1891095139 (847) 888-9000

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 60646 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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.

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 John Kelly's NPI number?

The NPI number for John Kelly is 1619171121. It was assigned to this individual provider in the NPPES registry on June 11, 2007.

Where is John Kelly located?

John Kelly practices at 5350 W Devon Avenue, Chicago, IL 60646. The listed phone number is (773) 631-6844.

What is John Kelly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is John Kelly enrolled in Medicare?

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

Which organizations bill Medicare for John Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Kelly reassigns Medicare benefits to 2 organizations: Head & Neck Cosmetic Surgery Associates LLC (Skokie, IL) and Specialty Care Institute, PLLC (Elgin, IL). 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 John 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 John Kelly 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.