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MS. SUSAN M KELLY NNP
NPI 1679114581
Pediatrics - Neonatal-Perinatal Medicine in Baltimore, MD

Active since October 01, 2019PECOS Enrolled
900 S CATON AVE, BALTIMORE, MD 21229(667) 234-6000 Get Directions Write a Review

NPPES record last updated: October 1, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Susan M Kelly Nnp NPPES

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

MS. SUSAN M KELLY NNP (NPI 1679114581) is an individual neonatal-perinatal medicine provider in Baltimore, Maryland, licensed in Maryland (R239962) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679114581
Entity TypeIndividualFemale
Primary Taxonomy2080N0001X
Provider Legal NameMS. SUSAN M KELLYCredential: NNP
Location Address900 S CATON AVEBaltimore, MD 21229-5201
Mailing Address561 Hook RdWestminster, MD 21157-5963 · (315) 430-2066
Phone(667) 234-6000
Sole ProprietorNo
Enumeration DateOctober 1, 2019
✔ NPI 1679114581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in MD · R239962
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
900 S CATON AVE, Baltimore, MD 21229
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Susan M Kelly Nnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Billing Reassignment

Medicare enrollment records show Susan Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. Agnes Healthcare, Inc.
Same address
Clinical Medical Laboratory
900 CATON AVE
Baltimore, MD 21229
  • Reassigned Medicare billing, Maryland enrollment
  • 372 clinicians in this Medicare group
NPI 1164462925 (667) 234-3060

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. VICTORIA VOLTA MANGER CRNA
Nurse Anesthetist, Certified Registered
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-3045
DR. LISA N GRIMALDI M.D.
Internal Medicine
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (410) 368-6000
MRS. EMILY MARIE COCO LCSW-C
Social Worker (Clinical)
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (443) 240-7575
OBINNA MADU MD
Student in an Organized Health Care Education/Training Program
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-2718
STEPHANIE AGUILAR PA-C
Physician Assistant
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-6000
DR. BERSABEL HILAWI TEWODROS MD
Student in an Organized Health Care Education/Training Program
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-5724
AARATI THAKUR MD
Student in an Organized Health Care Education/Training Program
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-6000
AASTHA PRADHAN
Student in an Organized Health Care Education/Training Program
900 S CATON AVE
BALTIMORE, MD 21229
Baltimore City (667) 234-6000

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 Susan Kelly's NPI number?

The NPI number for Susan Kelly is 1679114581. It was assigned to this individual provider in the NPPES registry on October 1, 2019.

Where is Susan Kelly located?

Susan Kelly practices at 900 S Caton Ave, Baltimore, MD 21229. The listed phone number is (667) 234-6000.

What is Susan Kelly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Susan Kelly enrolled in Medicare?

Yes. Susan Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Susan Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Kelly reassigns Medicare benefits to St. Agnes Healthcare, Inc. (Baltimore, MD). The 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 Susan 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 Susan Kelly was last updated on October 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.