MRS. JEANNINE MARY KELLY C.R.N.A.
NPI 1710925821
Nurse Anesthetist, Certified Registered in Philadelphia, PA
About Mrs. Jeannine Mary Kelly C.r.n.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JEANNINE MARY KELLY C.R.N.A. (NPI 1710925821) is an individual nurse anesthetist, certified registered in Philadelphia, Pennsylvania, licensed in Pennsylvania (332116L) and active in the NPI registry since June 2006. She is a graduate of Other (2004).
NPPES Registry Identity
Specialties & Licenses
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 and accepts Medicare assignment
Mrs. Jeannine Mary Kelly C.r.n.a. 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 Reassignment
Medicare enrollment records show Jeannine Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Paoli, PA 19301
- Reassigned Medicare billing, Pennsylvania enrollment
- 13 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.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
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 Jeannine Kelly's NPI number?
The NPI number for Jeannine Kelly is 1710925821. It was assigned to this individual provider in the NPPES registry on June 2, 2006.
Where is Jeannine Kelly located?
Jeannine Kelly practices at 111 S 11th St # 8490, Philadelphia, PA 19107. The listed phone number is (215) 955-6161.
What is Jeannine Kelly's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Jeannine Kelly enrolled in Medicare?
Yes. Jeannine 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 organization bills Medicare for Jeannine Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeannine Kelly reassigns Medicare benefits to Ambulatory Anesthesia Specialists, P.C. (Paoli, PA). 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 Jeannine 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 Jeannine Kelly was last updated on June 30, 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.
# Mrs. Jeannine Mary Kelly, C.R.N.A. · NPI 1710925821
Nurse Anesthetist, Certified Registered physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since June 2, 2006.
## Identity
- **NPI:** 1710925821 (Entity type: Individual)
- **Enumerated:** June 2, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 332116L (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 111 S 11TH ST # 8490, Philadelphia, PA 19107-4824
- **Phone:** (215) 955-6161 · **Fax:** (215) 923-5507
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Ambulatory Anesthesia Specialists, P.C. (NPI 1649227372, Paoli, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2004
## Record status
- **NPPES last updated:** June 30, 2015
- **Other identifiers:** Medicare PIN 080447N7N (PA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1710925821) · Data from the CMS NPPES public registry.