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MR. PATRICK JAMES KELLY DDS
NPI 1629149372
Dentist in Lincoln Park, MI

Active since November 13, 2006PECOS Enrolled
4009 FORT ST, LINCOLN PARK, MI 48146(313) 928-8555(313) 928-1399 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Patrick James Kelly Dds NPPES

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

MR. PATRICK JAMES KELLY DDS (NPI 1629149372) is an individual dentist in Lincoln Park, Michigan, licensed in Michigan (2901016290) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629149372
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. PATRICK JAMES KELLYCredential: DDS
Location Address4009 FORT STLincoln Park, MI 48146-4110
Mailing Address4009 Fort StLincoln Park, MI 48146-4110 · (313) 928-8555 · Fax (313) 928-1399
Phone(313) 928-8555
Fax(313) 928-1399
Sole ProprietorNo
Enumeration DateNovember 13, 2006
Last NPPES UpdateMarch 22, 2017
✔ NPI 1629149372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MI · 2901016290
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.
4009 FORT ST, Lincoln Park, MI 48146
Open in Google Maps ↗

Other Identifiers 1

Medicaid3334958MI

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Patrick James 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 Reassignment

Medicare enrollment records show Patrick Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Patrick J Kelly DDS , P.C
Same address
General Practice
4009 FORT ST
Lincoln Park, MI 48146
  • Reassigned Medicare billing, Michigan enrollment
  • 2 clinicians in this Medicare group
NPI 1194081273 (313) 928-8555

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 48146 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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 2

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

PATRICK J KELLY DDS , P.C
Dentist (General Practice)
4009 FORT ST
LINCOLN PARK, MI 48146
Wayne County (313) 928-8555
DR. ROBERT JOHN MORA DDS
Student in an Organized Health Care Education/Training Program
4009 FORT ST
LINCOLN PARK, MI 48146
Wayne County (313) 928-8555

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 Patrick Kelly's NPI number?

The NPI number for Patrick Kelly is 1629149372. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Where is Patrick Kelly located?

Patrick Kelly practices at 4009 Fort St, Lincoln Park, MI 48146. The listed phone number is (313) 928-8555.

What is Patrick Kelly's specialty?

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

Is Patrick Kelly enrolled in Medicare?

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

Which organization bills Medicare for Patrick Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Patrick Kelly reassigns Medicare benefits to Patrick J Kelly DDS , P.C (Lincoln Park, MI). 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 Patrick Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Patrick Kelly accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Patrick Kelly 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 Patrick Kelly was last updated on March 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.