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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: October 18, 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
Phone(713) 928-2774
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
Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marise Kelly, M.d., P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Marise Kelly, M.D., P.A., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Marise Kelly, M.D.
Family Practice
NPI 1124056304
900 BROADWAY ST
Houston, TX 77012
(713) 929-2774
✔ PECOS✔ Accepts MedicareSame address
Nsuela Mukana, M.D.
Family Practice
NPI 1427284017
3208 BROADWAY ST
Houston, TX 77017
(713) 393-7337
✔ PECOS1.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.

Is Marise Kelly, M.D., P.A. enrolled in Medicare?

Yes. Marise Kelly, M.D., P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Marise Kelly, M.D., P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Marise Kelly, M.D., P.A.. A 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 the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 WellPoint 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.