DAVID ALLEN KELLY JR. CRNP
NPI 1639930779
Nurse Practitioner - Family in Portland, OR
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
Specialties & Licenses
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.
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, PAPhysician 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.
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.
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 David Kelly's NPI number?
The NPI number for David Kelly is 1639930779. It was assigned to this individual provider in the NPPES registry on January 16, 2024.
Where is David Kelly located?
David Kelly practices at 3303 S Bond Ave, Portland, OR 97239. The listed phone number is (503) 494-6346.
What is David Kelly's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is David Kelly enrolled in Medicare?
Yes. David 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.
Is David Kelly affiliated with any hospitals?
According to CMS data, David Kelly is affiliated with Hospital Of Univ Of Pennsylvania.
When was this NPI record last updated?
The NPPES record for David Kelly was last updated on May 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# David Allen Kelly Jr., CRNP · NPI 1639930779
Family physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since January 16, 2024.
## Identity
- **NPI:** 1639930779 (Entity type: Individual)
- **Enumerated:** January 16, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 202207583NP-PP (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3303 S BOND AVE, Portland, OR 97239-4501
- **Phone:** (503) 494-6346 · **Fax:** (503) 494-5385
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** May 7, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1639930779) · Data from the CMS NPPES public registry.