DR. PETER H KELLY MD
NPI 1669447850
Surgery in Saint Paul, MN
About Dr. Peter H Kelly Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PETER H KELLY MD (NPI 1669447850) is an individual surgery provider in Saint Paul, Minnesota, licensed in Minnesota (29590) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Peter H Kelly Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Peter Kelly reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Paul, MN 55102
- Reassigned Medicare billing, Minnesota enrollment
- 3,633 clinicians in this Medicare group
Saint Paul, MN 55102
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Healtheast Medical Research Institute
- 2,361 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
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 55102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT PAUL, MN 55102
SAINT PAUL, MN 55102
SAINT PAUL, MN 55102
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 Peter Kelly's NPI number?
The NPI number for Peter Kelly is 1669447850. It was assigned to this individual provider in the NPPES registry on February 21, 2006.
Where is Peter Kelly located?
Peter Kelly practices at 310 Smith Ave N, Saint Paul, MN 55102. The listed phone number is (952) 843-4333.
What is Peter Kelly's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Peter Kelly enrolled in Medicare?
Yes. Peter Kelly is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Peter Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Peter Kelly reassigns Medicare benefits to 3 organizations: Fairview Express Care (Saint Paul, MN), Healtheast Medical Research Insititue (Saint Paul, MN) and Fairview Health Services (Minneapolis, MN). 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 Peter 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 Peter Kelly was last updated on November 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Peter H Kelly, MD · NPI 1669447850
Surgery physician in Saint Paul, Minnesota. Individual provider, active in the CMS NPPES registry since February 21, 2006.
## Identity
- **NPI:** 1669447850 (Entity type: Individual)
- **Enumerated:** February 21, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 29590 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 310 SMITH AVE N, Saint Paul, MN 55102-2393
- **Phone:** (952) 843-4333 · **Fax:** (952) 843-4301
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Fairview Express Care (NPI 1275277204, Saint Paul, MN); Healtheast Medical Research Insititue (NPI 1417145517, Saint Paul, MN); Fairview Health Services (NPI 1316008212, Minneapolis, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 23, 2020
- **Other identifiers:** Medicaid 392777600 (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1669447850) · Data from the CMS NPPES public registry.