SHANNON KELLY M.D
NPI 1669792107
Pediatrics - Pediatric Hematology-Oncology in San Francisco, CA
About Shannon Kelly M.d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANNON KELLY M.D (NPI 1669792107) is an individual pediatric hematology-oncology provider in San Francisco, California, licensed in California (A100334) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2003).
NPPES Registry Identity
Specialties & Licenses 2
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
Shannon Kelly M.d 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.
Medicare Billing Reassignments
3Medicare enrollment records show Shannon Kelly reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Francisco, CA 94122
- Reassigned Medicare billing, California enrollment
- 5,544 clinicians in this Medicare group
San Francisco, CA 94143
- Reassigned Medicare billing, California enrollment
- 5,645 clinicians in this Medicare group
San Francisco, CA 94143
- Reassigned Medicare billing, California enrollment
- 1,159 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.
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 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN FRANCISCO, CA 94118
SAN FRANCISCO, CA 94118
SAN FRANCISCO, CA 94118
SAN FRANCISCO, CA 94118
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 Shannon Kelly's NPI number?
The NPI number for Shannon Kelly is 1669792107. It was assigned to this individual provider in the NPPES registry on June 7, 2010.
Where is Shannon Kelly located?
Shannon Kelly practices at 270 Masonic Ave, San Francisco, CA 94118. The listed phone number is (504) 319-1574.
What is Shannon Kelly's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.
Is Shannon Kelly enrolled in Medicare?
Yes. Shannon 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 Shannon Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Kelly reassigns Medicare benefits to 3 organizations: Ucsf Medical Group Business Services (San Francisco, CA), University Of California San Francisco (San Francisco, CA) and Ucsf Pediatrics Associates (San Francisco, CA). 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 Shannon 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 Shannon Kelly was last updated on May 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Shannon Kelly, M.D · NPI 1669792107
Pediatric Hematology-Oncology physician in San Francisco, California. Individual provider, active in the CMS NPPES registry since June 7, 2010.
## Identity
- **NPI:** 1669792107 (Entity type: Individual)
- **Enumerated:** June 7, 2010
- **Primary specialty:** Pediatrics - Pediatric Hematology-Oncology · taxonomy 2080P0207X
- **State license:** A100334 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 270 MASONIC AVE, San Francisco, CA 94118-4417
- **Phone:** (504) 319-1574
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **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): Ucsf Medical Group Business Services (NPI 1477624104, San Francisco, CA); University Of California San Francisco (NPI 1164512851, San Francisco, CA); Ucsf Pediatrics Associates (NPI 1376614016, San Francisco, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** May 13, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1669792107) · Data from the CMS NPPES public registry.