SHANNON KELLY M.D
NPI 1669792107
Pediatrics - Pediatric Hematology-Oncology in San Francisco, CA

Active since June 07, 2010PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
270 MASONIC AVE, SAN FRANCISCO, CA 94118(504) 319-1574 Get Directions Write a Review

NPPES record last updated: May 13, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

NPI1669792107
Entity TypeIndividualFemale
Primary Taxonomy2080P0207X
Provider Legal NameSHANNON KELLYCredential: M.D
Location Address270 MASONIC AVESan Francisco, CA 94118-4417
Mailing Address3201 Cutter WaySacramento, CA 95818-4437 · (504) 319-1574
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJune 7, 2010
Last NPPES UpdateMay 13, 2015
NPI 1669792107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License Licensed in CA · A100334
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Also ListedPathology · Blood Banking & Transfusion MedicineTaxonomy 207ZB0001X · License 100334 (CA)
270 MASONIC AVE, San Francisco, CA 94118

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

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.

PECOS PAC ID7012247505
PECOS Enrollment IDI20190926000248
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 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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.

Pathology (Clinical Pathology/Laboratory Medicine)
270 MASONIC AVE
SAN FRANCISCO, CA 94118
Pathology (Blood Banking & Transfusion Medicine)
270 MASONIC AVE
SAN FRANCISCO, CA 94118
Pathology (Blood Banking & Transfusion Medicine)
270 MASONIC AVE
SAN FRANCISCO, CA 94118
Blood Bank
270 MASONIC AVE
SAN FRANCISCO, CA 94118
General Acute Care Hospital
270 MASONIC AVE
SAN FRANCISCO, CA 94118
Internal Medicine
270 MASONIC AVE
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.

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.