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DR. ROBERT J. KELLY D.D.S.
NPI 1922060763
Dentist - General Practice in Albuquerque, NM

Active since April 05, 2006Opted out of Medicare · through Jul 21, 2027
3901 LOUISIANA BLVD NE, SUITE B, ALBUQUERQUE, NM 87110(505) 881-2421(505) 881-2841 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Robert J. Kelly D.d.s. NPPES

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

DR. ROBERT J. KELLY D.D.S. (NPI 1922060763) is an individual general practice provider in Albuquerque, New Mexico, licensed in New Mexico (NMLL57) and active in the NPI registry since April 2006. He has opted out of Medicare through July 21, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1922060763
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ROBERT J. KELLYCredential: D.D.S.
Location Address3901 LOUISIANA BLVD NE, SUITE BAlbuquerque, NM 87110-1577
Mailing Address3901 Louisiana Blvd Ne, Suite BAlbuquerque, NM 87110-1577 · (505) 881-2421 · Fax (505) 881-2841
Phone(505) 881-2421
Fax(505) 881-2841
Sole ProprietorYes
Enumeration DateApril 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1922060763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NM · NMLL57
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3901 LOUISIANA BLVD NE, Albuquerque, NM 87110
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Robert J. Kelly D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 21, 2015 through July 21, 2027.

Opt-Out Effective DateJuly 21, 2015
Opt-Out In Effect ThroughJuly 21, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87110 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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. JAMES G GLASA DMD
Dentist (General Practice)
3901 LOUISIANA BLVD NE, SUITE C
ALBUQUERQUE, NM 87110
Bernalillo County (505) 888-7545
WILSON RADIOGRAPHIC CENTER OF ALBUQUERQUE, INC
Dental Laboratory
3901 LOUISIANA BLVD NE, SUITE E
ALBUQUERQUE, NM 87110
Bernalillo County (505) 883-5066
SALLY CARLON LPCC
Counselor (Professional)
3901 LOUISIANA BLVD NE, SUITE C
ALBUQUERQUE, NM 87110
Bernalillo County (505) 888-1686
DR. DENNIS G. FILLMORE D.D.S.
Dentist (General Practice)
3901 LOUISIANA BLVD NE
ALBUQUERQUE, NM 87110
Bernalillo County (505) 883-4649
MRS. MELISSA JEANETTE ADKINS LPCC
Counselor (Mental Health)
3901 LOUISIANA BLVD NE, SUITE C
ALBUQUERQUE, NM 87110
Bernalillo County (505) 507-6339

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 Robert Kelly's NPI number?

The NPI number for Robert Kelly is 1922060763. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Robert Kelly located?

Robert Kelly practices at 3901 Louisiana Blvd NE Suite B, Albuquerque, NM 87110. The listed phone number is (505) 881-2421.

What is Robert Kelly's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Robert Kelly enrolled in Medicare?

No. Robert Kelly has opted out of Medicare through July 21, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Robert Kelly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.