MR. TIMOTHY P KELLEY PA-C
NPI 1679654057
Physician Assistant in Mooresville, NC

Active since October 18, 2006PECOS EnrolledAccepts Medicare Assignment
202 WILLIAMSON RD STE 100, MOORESVILLE, NC 28117(704) 799-7811(704) 799-7812 Get Directions Write a Review

NPPES record last updated: September 9, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 9, 2020, Oct 19, 2017, Oct 24, 2016 (3 updates tracked since 2016).

About Mr. Timothy P Kelley Pa-c NPPES

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

MR. TIMOTHY P KELLEY PA-C (NPI 1679654057) is an individual physician assistant in Mooresville, North Carolina, licensed in North Carolina (001000651) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1679654057
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. TIMOTHY P KELLEYCredential: PA-C
Location Address202 WILLIAMSON RD STE 100Mooresville, NC 28117-7610
Mailing Address202 Williamson Rd, Ste 100Mooresville, NC 28117-7610 · (704) 799-7811 · Fax (704) 799-7812
Fax(704) 799-7812
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateOctober 18, 2006
Last NPPES UpdateSeptember 9, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2020
NPI 1679654057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NC · 001000651
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

202 WILLIAMSON RD STE 100, Mooresville, NC 28117

Other Identifiers 3

Medicaid8101237NC
Medicaid085001277IL
Medicaid1679654057NC

Accepted Insurance

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

Mr. Timothy P Kelley Pa-c 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 ID1658330949
PECOS Enrollment IDI20071213000238
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.

Areas of Expertise CMS Part B claims 28

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
110 services69 patients
Albumin (protein) level 82040
The Albumin Level test measures the amount of albumin, a vital protein made by the liver, in your blood. This protein helps keep fluid in your bloodstream so it doesn't leak into other tissues. It's also vital for tissue growth and healing. Low or high levels can indicate certain health issues.
54 services43 patients
Bilirubin level, total 82247
A total bilirubin level test is a blood test that helps check how well your liver is functioning. It measures bilirubin, a yellow substance your body creates when it breaks down red blood cells. High levels may indicate a problem with your liver or bile duct.
54 services43 patients
Calcium level, total 82310
A total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.
54 services43 patients
Blood chloride level 82435
A blood chloride level test measures the amount of chloride, a type of electrolyte, in your blood. Electrolytes help balance the amount of fluids in your body and maintain your body's acid-base balance. This test can help diagnose health issues like kidney diseases, liver diseases, and heart failure.
54 services43 patients
Blood creatinine level 82565
A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.
54 services43 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
48%178 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
55%384 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
44%68 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers17 claims17 services$63.19 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
202 WILLIAMSON RD STE 100
MOORESVILLE, NC 28117
Internal Medicine
202 WILLIAMSON RD STE 100
MOORESVILLE, NC 28117
Physician Assistant
202 WILLIAMSON RD STE 100
MOORESVILLE, NC 28117

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679654057, enumerated as an "individual" on October 18, 2006.

The provider is located at 202 WILLIAMSON RD STE 100 MOORESVILLE, NC 28117 and the phone number is (704) 799-7811.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Medicare and. Please consult your insurance carrier or call the provider to verify.