TAYLOR KELLAM
NPI 1740965326
Physician Assistant in Green Bay, WI

Q: What is Taylor Kellam's NPI number?

The NPI number for Taylor Kellam is 1740965326. It was assigned to this individual provider in the NPPES registry on June 20, 2023.

Q: What is Taylor Kellam's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Taylor Kellam was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since June 20, 2023PECOS Enrolled

835 S VAN BUREN ST, GREEN BAY, WI 54301(920) 433-0111 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 15, 2026, Jun 20, 2023 (2 updates tracked since 2023).

On this page

About Taylor Kellam NPPES

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

TAYLOR KELLAM (NPI 1740965326) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (8441-23) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1740965326

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameTAYLOR KELLAM

Location Address835 S VAN BUREN STGreen Bay, WI 54301-3526

Mailing Address835 S Van Buren StGreen Bay, WI 54301-3526 · (920) 433-0111

Phone(920) 433-0111

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateJune 20, 2023

Last NPPES UpdateFebruary 10, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2026

✔ NPI 1740965326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 8441-23

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.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 8441-23 (WI)

835 S VAN BUREN ST, Green Bay, WI 54301

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Taylor Kellam is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224530001

PECOS Enrollment IDI20250909002755

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number520097

Location1726 Shawano AveGreen Bay, WI 54303 · Brown County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

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.

MARY LYNN BARTEL MD

Pediatrics

835 S VAN BUREN ST, ROOM 1041
GREEN BAY, WI 54301

Brown County (920) 496-4700

DR. EKMINI WIJESINGHE MD

Hospitalist

835 S VAN BUREN ST, ST VINCENT HOSPITAL
GREEN BAY, WI 54301

Brown County (920) 272-1586

SALLY SCHLISE MD

Radiology (Radiation Oncology)