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CAROLYN KELLY D.P.M.
NPI 1619264041
Podiatrist - Foot & Ankle Surgery in Bolingbrook, IL

Active since July 06, 2011PECOS EnrolledAccepts Medicare Assignment
396 REMINGTON BLVD STE 370, BOLINGBROOK, IL 60440(630) 418-6601(630) 312-2223 Get Directions Write a Review

NPPES record last updated: August 12, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 12, 2019, Jul 16, 2019 (2 updates tracked since 2019).

About Carolyn Kelly D.p.m. NPPES

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

CAROLYN KELLY D.P.M. (NPI 1619264041) is an individual foot & ankle surgery provider in Bolingbrook, Illinois, licensed in Illinois (016.005524) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, is affiliated with John H Stroger Jr Hospital, and maintains a secondary practice location in Bolingbrook.

NPPES Registry Identity

NPI1619264041
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameCAROLYN KELLYCredential: D.P.M.
Location Address396 REMINGTON BLVD STE 370Bolingbrook, IL 60440-4302
Mailing Address396 Remington Blvd Ste 370Bolingbrook, IL 60440-4302 · (630) 418-6601 · Fax (630) 312-2223
Phone(630) 418-6601
Fax(630) 312-2223
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 6, 2011
Last NPPES UpdateAugust 12, 20192 updates tracked since enumeration
✔ NPI 1619264041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in IL · 016.005524
Also ListedPodiatristTaxonomy 213E00000X · License 135000752 (IL)
Also ListedPodiatrist · Foot SurgeryTaxonomy 213ES0131X · License 016005524 (IL)
396 REMINGTON BLVD STE 370, Bolingbrook, IL 60440
Open in Google Maps ↗

Secondary Practice Location 1

Location 1256 Tudor CourtBolingbrook, IL 60440-2056 · Phone (630) 294-0810

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carolyn Kelly D.p.m. 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 ID941424675
PECOS Enrollment IDI20140618002303
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 Carolyn Kelly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cook County
19 mi
Primary Care
1800 S. HARLEM AVE
Riverside, IL 60546
  • Reassigned Medicare billing, Illinois enrollment
  • 1,047 clinicians in this Medicare group
NPI 1497875298 (708) 783-9800
Elgin Foot & Ankle Center, S.C.
29 mi
Foot & Ankle Surgery
750 FLETCHER DR STE 300
Elgin, IL 60123
  • Reassigned Medicare billing, Illinois enrollment
  • 7 clinicians in this Medicare group
NPI 1639270663 (847) 741-3127

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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 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.
97 services72 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
17 services17 patients
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.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

John H Stroger Jr Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number140124
Location1901 W Harrison StChicago, IL 60612 · Cook County
Emergency services Birthing friendly

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 Carolyn Kelly's NPI number?

The NPI number for Carolyn Kelly is 1619264041. It was assigned to this individual provider in the NPPES registry on July 6, 2011.

Where is Carolyn Kelly located?

Carolyn Kelly practices at 396 Remington Blvd Ste 370, Bolingbrook, IL 60440. The listed phone number is (630) 418-6601.

What is Carolyn Kelly's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Carolyn Kelly enrolled in Medicare?

Yes. Carolyn Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Carolyn Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Kelly reassigns Medicare benefits to 2 organizations: Cook County (Riverside, IL) and Elgin Foot & Ankle Center, S.C. (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 Carolyn Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Carolyn Kelly affiliated with any hospitals?

According to CMS data, Carolyn Kelly is affiliated with John H Stroger Jr Hospital.

When was this NPI record last updated?

The NPPES record for Carolyn Kelly was last updated on August 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.