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JASMINE MARIE KELLY MD
NPI 1871090845
Internal Medicine in Ewa Beach, HI

Active since April 06, 2018PECOS EnrolledAccepts Medicare Assignment
91-2139 FORT WEAVER RD STE 303, EWA BEACH, HI 96706(808) 678-0700 Get Directions Write a Review

NPPES record last updated: June 14, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jasmine Marie Kelly Md NPPES

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

JASMINE MARIE KELLY MD (NPI 1871090845) is an individual internal medicine provider in Ewa Beach, Hawaii, licensed in Hawaii (21796) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS, is affiliated with The Queens Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1871090845
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameJASMINE MARIE KELLYCredential: MD
Location Address91-2139 FORT WEAVER RD STE 303Ewa Beach, HI 96706-3609
Mailing Address91-2139 Fort Weaver Rd Ste 303Ewa Beach, HI 96706-3609 · (808) 678-0700 · Fax (808) 678-0776
Phone(808) 678-0700
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 6, 2018
Last NPPES UpdateJune 14, 2021
NPPES CertifiedJune 14, 2021
✔ NPI 1871090845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in HI · 21796
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
91-2139 FORT WEAVER RD STE 303, Ewa Beach, HI 96706
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jasmine Marie Kelly Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103179411
PECOS Enrollment IDI20210916001893
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.

Medicare Billing Reassignment

Medicare enrollment records show Jasmine Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Russell S Kelly MD LLC
Same address
Primary Care
91-2139 FORT WEAVER RD, SUITE 300
Ewa Beach, HI 96706
  • Reassigned Medicare billing, Hawaii enrollment
  • 2 clinicians in this Medicare group
NPI 1598810814 (808) 678-0700

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
307 services135 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
85 services85 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
77 services77 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
39 services32 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
22 services19 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
17 services16 patients

Hospital Affiliations CMS Care Compare 2

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

The Queens Medical Center

Acute Care Hospitals · Honolulu, HI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number120001
Location1301 Punchbowl StHonolulu, HI 96813 · Honolulu County
Emergency services Birthing friendly

Pali Momi Medical Center

Acute Care Hospitals · Aiea, HI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number120026
Location98-1079 Moanalua RoadAiea, HI 96701 · Honolulu County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96706 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
$136.68 typical visit price
range $60.53 – $180.05
Typical copayment $34.17 (range $15.13 – $45.01)
Most-billed visit code 99204
Established Patient
$105.65 typical visit price
range $20.09 – $147.56
Typical copayment $26.41 (range $5.02 – $36.89)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jasmine Kelly's NPI number?

The NPI number for Jasmine Kelly is 1871090845. It was assigned to this individual provider in the NPPES registry on April 6, 2018.

Where is Jasmine Kelly located?

Jasmine Kelly practices at 91-2139 Fort Weaver Rd Ste 303, Ewa Beach, HI 96706. The listed phone number is (808) 678-0700.

What is Jasmine Kelly's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jasmine Kelly enrolled in Medicare?

Yes. Jasmine Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jasmine Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jasmine Kelly reassigns Medicare benefits to Russell S Kelly MD LLC (Ewa Beach, HI). The 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 Jasmine Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jasmine Kelly accept?

Health plans from HMSA list Jasmine Kelly 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.

Is Jasmine Kelly affiliated with any hospitals?

According to CMS data, Jasmine Kelly is affiliated with The Queens Medical Center and Pali Momi Medical Center.

When was this NPI record last updated?

The NPPES record for Jasmine Kelly was last updated on June 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.