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BROOKS BRENDEN KELLY MD
NPI 1770148066
Surgery - Plastic and Reconstructive Surgery in Southlake, TX

Active since May 02, 2019PECOS Enrolled
415 E SOUTHLAKE BLVD STE 101, SOUTHLAKE, TX 76092(817) 809-3155 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 19, 2025, Jun 17, 2024, May 2, 2019 (3 updates tracked since 2019).

About Brooks Brenden Kelly Md NPPES

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

BROOKS BRENDEN KELLY MD (NPI 1770148066) is an individual plastic and reconstructive surgery provider in Southlake, Texas, licensed in Texas (V6040) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770148066
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameBROOKS BRENDEN KELLYCredential: MD
Location Address415 E SOUTHLAKE BLVD STE 101Southlake, TX 76092-6279
Mailing Address415 E Southlake Blvd Ste 101Southlake, TX 76092-6279 · (817) 809-3155
Phone(817) 809-3155
Sole ProprietorNo
Enumeration DateMay 2, 2019
Last NPPES UpdateJune 19, 20253 updates tracked since enumeration
NPPES CertifiedJune 19, 2025
✔ NPI 1770148066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Licenses✔ Licensed in TX · V6040✔ Licensed in VA · 0116032687
Definition

A surgeon who specializes in plastic and reconstructive surgery.

415 E SOUTHLAKE BLVD STE 101, Southlake, TX 76092
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooks Brenden Kelly Md 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.

Other Providers at the Same Location NPPES 5

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

DR. CASEY L ANDERSON M.D.
Student in an Organized Health Care Education/Training Program
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
DR. JACOB CARLSON MD
Surgery
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
DR. GRANT ALEXANDER BOND M.D.
Surgery (Plastic and Reconstructive Surgery)
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
ARVIND MANISUNDARAM
Surgery (Plastic and Reconstructive Surgery)
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
TAYLOR ANN CHISHOM MD MPH
Plastic Surgery
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (972) 636-4902

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 Brooks Kelly's NPI number?

The NPI number for Brooks Kelly is 1770148066. It was assigned to this individual provider in the NPPES registry on May 2, 2019.

Where is Brooks Kelly located?

Brooks Kelly practices at 415 E Southlake Blvd Ste 101, Southlake, TX 76092. The listed phone number is (817) 809-3155.

What is Brooks Kelly's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Brooks Kelly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Brooks Kelly was last updated on June 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.