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MRS. KELLY RENET DALE P.A.
NPI 1952468530
Physician Assistant - Medical in Sandusky, MI

Active since January 02, 2007PECOS EnrolledAccepts Medicare Assignment
95.7/100
CMS Quality Rating
416 WOODLAND DR, SANDUSKY, MI 48471(810) 202-6022(810) 682-4026 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 19, 2024, Oct 5, 2021, Aug 18, 2021 and 1 more (4 updates tracked since 2021).

About Mrs. Kelly Renet Dale P.a. NPPES

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

MRS. KELLY RENET DALE P.A. (NPI 1952468530) is an individual medical provider in Sandusky, Michigan, licensed in Michigan (5601003127) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Covenant Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1952468530
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. KELLY RENET DALECredential: P.A.
Location Address416 WOODLAND DRSandusky, MI 48471-1047
Mailing Address2690 Germania RdMarlette, MI 48453-8965 · (810) 577-7395
Phone(810) 202-6022
Fax(810) 682-4026
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJanuary 2, 2007
Last NPPES UpdateNovember 19, 20244 updates tracked since enumeration
NPPES CertifiedNovember 19, 2024
✔ NPI 1952468530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MI · 5601003127
416 WOODLAND DR, Sandusky, MI 48471
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1150 Plymouth RdSaginaw, MI 48638-7135 · Phone (989) 323-3863 · Fax (989) 502-1122
Location 2154 S Main St Ste 6Frankenmuth, MI 48734-1692 · Phone (989) 502-1122 · Fax (989) 502-1212

Other Identifiers 1

Other5601003127MI · State License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kelly Renet Dale P.a. 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 ID3476597055
PECOS Enrollment IDI20050614001288
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.

Hospital Affiliations CMS Care Compare

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

Covenant Medical Center

Acute Care Hospitals · Saginaw, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230070
Location1447 N HarrisonSaginaw, MI 48602 · Saginaw County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.11
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

ANKLE & FOOT SPECIALTY CLINICS, LLC
Podiatrist (Foot & Ankle Surgery)
416 WOODLAND DR
SANDUSKY, MI 48471
Sanilac County (810) 414-3338
ANKLE AND FOOT SPECIALTY CLINICS
Podiatrist (Foot & Ankle Surgery)
416 WOODLAND DR
SANDUSKY, MI 48471
Sanilac County (810) 414-3338

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 Kelly Dale's NPI number?

The NPI number for Kelly Dale is 1952468530. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Where is Kelly Dale located?

Kelly Dale practices at 416 Woodland Dr, Sandusky, MI 48471. The listed phone number is (810) 202-6022.

What is Kelly Dale's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kelly Dale enrolled in Medicare?

Yes. Kelly Dale 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.

What insurance does Kelly Dale accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Kelly Dale 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 Kelly Dale affiliated with any hospitals?

According to CMS data, Kelly Dale is affiliated with Covenant Medical Center.

When was this NPI record last updated?

The NPPES record for Kelly Dale was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.