MARISE KELLY, M.D., P.A.
NPI 1790010064
Family Medicine in Houston, TX

Active since October 05, 2009CLIA 45D0953648 · Waiver
900 BROADWAY ST, HOUSTON, TX 77012(713) 928-2774(713) 928-2781 Get Directions Write a Review

NPPES record last updated: May 27, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Marise Kelly, M.d., P.a. NPPES

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

MARISE KELLY, M.D., P.A. (NPI 1790010064) is a healthcare organization registered as a family medicine in Houston, Texas and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through April 27, 2027 and lists Marise Kelly, Director, as its authorized official.

NPPES Registry Identity

NPI1790010064
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMARISE KELLY, M.D., P.A.
Location Address900 BROADWAY STHouston, TX 77012-2127
Mailing Address900 Broadway StHouston, TX 77012-2127 · (713) 928-2774 · Fax (713) 928-2781
Fax(713) 928-2781
Organization SubpartNo
Authorized OfficialMarise KellyDirector · (713) 928-2774
Enumeration DateOctober 5, 2009
Last NPPES UpdateMay 27, 2011
NPI 1790010064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TX · J9727
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
900 BROADWAY ST, Houston, TX 77012

Other Identifiers 3

Medicaid219659401TX
Medicaid219659402TX
Medicare PIN0A5842TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0953648

Marise Kelly MD PA Dba Broadway Clinic · Houston, TX
Active · expires Apr 27, 2027
CLIA Number45D0953648
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 28, 2025
Certificate Expiration DateApril 27, 2027
Laboratory DirectorMarise Kelly
Laboratory Phone(713) 928-2774
Laboratory LocationMarise Kelly MD PA Dba Broadway Clinic900 Broadway, Houston, TX 77012
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

Family Medicine
900 BROADWAY ST
HOUSTON, TX 77012
Dentist (General Practice)
900 BROADWAY ST
HOUSTON, TX 77012
Dentist (General Practice)
900 BROADWAY ST
HOUSTON, TX 77012
Dentist (Orthodontics and Dentofacial Orthopedics)
900 BROADWAY ST
HOUSTON, TX 77012
Psychiatry & Neurology (Psychiatry)
900 BROADWAY ST
HOUSTON, TX 77012
Pharmacist
900 BROADWAY ST
HOUSTON, TX 77012
Dentist (General Practice)
900 BROADWAY ST
HOUSTON, TX 77012

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 Marise Kelly, M.D., P.A.'s NPI number?

The NPI number for Marise Kelly, M.D., P.A. is 1790010064. It was assigned to this organization in the NPPES registry on October 5, 2009.

Where is Marise Kelly, M.D., P.A. located?

Marise Kelly, M.D., P.A. is located at 900 Broadway St, Houston, TX 77012. The listed phone number is (713) 928-2774.

What is Marise Kelly, M.D., P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Marise Kelly, M.D., P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0953648) is associated with this NPI, valid through April 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Marise Kelly, M.D., P.A. accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 3 other insurers list Marise Kelly, M.D., P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marise Kelly, M.D., P.A. was last updated on May 27, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.