Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

TYLER QUINN KELLIS MD
NPI 1790513703
Student in an Organized Health Care Education/Training Program in Aurora, CO

Q: What is Tyler Kellis's NPI number?

The NPI number for Tyler Kellis is 1790513703. It was assigned to this individual provider in the NPPES registry on July 22, 2024.

Q: What is Tyler Kellis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Kellis was last updated on July 8, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 22, 2024PECOS Enrolled

1400 S POTOMAC ST STE 250, AURORA, CO 80012(303) 531-4910 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 8, 2026, Jul 22, 2024 (2 updates tracked since 2024).

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About Tyler Quinn Kellis Md NPPES

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

TYLER QUINN KELLIS MD (NPI 1790513703) is an individual student in an organized health care education/training program in Aurora, Colorado, licensed in Colorado (TL.0010816) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790513703

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTYLER QUINN KELLISCredential: MD

Location Address1400 S POTOMAC ST STE 250Aurora, CO 80012-4541

Mailing Address1400 S Potomac St Ste 250Aurora, CO 80012-4541 · (303) 531-4910

Phone(303) 531-4910

Sole ProprietorYes

Enumeration DateJuly 22, 2024

Last NPPES UpdateJuly 8, 20262 updates tracked since enumeration

NPPES CertifiedJuly 8, 2026

✔ NPI 1790513703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in CO · TL.0010816

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1400 S POTOMAC ST STE 250, Aurora, CO 80012

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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)

Tyler Quinn Kellis 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.

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