1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Nurse Practitioner
  6. NPI Profile

DAVID ALLEN KELLY JR. CRNP
NPI 1639930779
Nurse Practitioner - Family in Portland, OR

Active since January 16, 2024PECOS EnrolledAccepts Medicare Assignment
3303 S BOND AVE, PORTLAND, OR 97239(503) 494-6346(503) 494-5385 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About David Allen Kelly Jr. Crnp NPPES

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

DAVID ALLEN KELLY JR. CRNP (NPI 1639930779) is an individual family provider in Portland, Oregon, licensed in Oregon (202207583NP-PP) and active in the NPI registry since January 2024. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1639930779
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDAVID ALLEN KELLY JR.Credential: CRNP
Location Address3303 S BOND AVEPortland, OR 97239-4501
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · (866) 617-6855 · Fax (503) 346-8015
Phone(503) 494-6346
Fax(503) 494-5385
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJanuary 16, 2024
Last NPPES UpdateMay 7, 2024
NPPES CertifiedMay 7, 2024
✔ NPI 1639930779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 202207583NP-PP
3303 S BOND AVE, Portland, OR 97239
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David Allen Kelly Jr. Crnp 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 ID9830539576
PECOS Enrollment IDI20241108001491
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.

Hospital Affiliations CMS Care Compare

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
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 20

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

DR. STEPHANIE G WOOD
Surgery
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-4373
RACHEL K. BOLOGNONE M.S. SLP-CCC
Speech-Language Pathologist
3303 S BOND AVE, SUITE 15
PORTLAND, OR 97239
Multnomah County (503) 494-5947
SARAH ANN GANG MOTR/L, CLT-LANA
Occupational Therapist
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-3151
DR. ERIN FOSTER M.D., PH.D.
Dermatology
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 418-3376
SHAYNE NICOLE WILLIS BAKER PT, DPT, ATC, CIMT
Physical Medicine & Rehabilitation
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-3151
DAVID RICHARD MURPHY PA
Physician Assistant (Medical)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-8573
CARRIE CRINO M.S., CCC-SLP
Speech-Language Pathologist
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-5947
DR. ROBERT LANGLAND EIL MD
Surgery
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-5501

Frequently Asked Questions

What is David Kelly's NPI number?

The NPI number assigned to this healthcare provider is 1639930779, enumerated as an "individual" on January 16, 2024.

Where is the provider located?

The provider is located at 3303 S BOND AVE PORTLAND, OR 97239 and the phone number is (503) 494-6346.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Is David Kelly affiliated with any hospitals?

David Kelly is affiliated with: HOSPITAL OF UNIV OF PENNSYLVANIA.