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KELLY GILMORE MD
NPI 1962697417
Colon & Rectal Surgery in Houston, TX

Active since September 07, 2007PECOS EnrolledAccepts Medicare Assignment
89.44/100
CMS Quality Rating
6550 FANNIN ST, STE 2307, HOUSTON, TX 77030(713) 790-9250 Get Directions Write a Review

NPPES record last updated: October 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kelly Gilmore Md NPPES

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

KELLY GILMORE MD (NPI 1962697417) is an individual colon & rectal surgery provider in Houston, Texas, licensed in Texas (M7213) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS, is affiliated with Hca Houston Healthcare Conroe, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1962697417
Entity TypeIndividualFemale
Primary Taxonomy208C00000X
Provider Legal NameKELLY GILMORECredential: MD
Location Address6550 FANNIN ST, STE 2307Houston, TX 77030-2717
Mailing Address508 Medical Center Blvd Ste 150Conroe, TX 77304-2845 · (936) 494-2201 · Fax (936) 494-2217
Phone(713) 790-9250
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateSeptember 7, 2007
Last NPPES UpdateOctober 4, 2019
✔ NPI 1962697417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in TX · M7213
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
6550 FANNIN ST, Houston, TX 77030
Open in Google Maps ↗

Other Identifiers 1

Medicaid190579602TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Kelly Gilmore 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 ID3678656451
PECOS Enrollment IDI20080218000162
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.

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 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.
95 services52 patients
Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
62 services47 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
39 services39 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
29 services29 patients
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.
26 services21 patients
Removal of external hemorrhoids by rubber banding 46221
Rubber band ligation is a procedure used to treat external hemorrhoids. A doctor places small rubber bands around the base of the hemorrhoids. This cuts off blood supply, causing them to shrink and fall off, typically within a week.
18 services13 patients

Hospital Affiliations CMS Care Compare

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

Hca Houston Healthcare Conroe

Acute Care Hospitals · Conroe, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450222
Location504 Medical Center BlvdConroe, TX 77304 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
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.

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.

89.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.85
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

MEGAN MCCLANAHAN
Student in an Organized Health Care Education/Training Program
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 441-5155
MARIANNE CARLSON PSYD
Psychologist (Clinical)
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (346) 248-2040
MARIE MCLAIN P.A.
Physician Assistant
6550 FANNIN ST, SMITH TOWER, SUITE 1901
HOUSTON, TX 77030
Harris County (713) 441-1100
DALIA MOGHAZY MD
Obstetrics & Gynecology
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 790-3311
YVONNE I-FANG CHU M.D.
Ophthalmology
6550 FANNIN ST, SUITE 1501
HOUSTON, TX 77030
Harris County (713) 798-6100
DR. SAM JERRY LONG D.D.S.
Dentist (General Practice)
6550 FANNIN ST, STE 2103
HOUSTON, TX 77030
Harris County (713) 797-0846
THOMAS W KNIGHT MD
Internal Medicine
6550 FANNIN ST, SMITH 1101
HOUSTON, TX 77030
Harris County (713) 441-0006
DR. JOOHI JIMENEZ-SHAHED M.D.
Psychiatry & Neurology (Neurology)
6550 FANNIN ST, SUITE 1801
HOUSTON, TX 77030
Harris County (713) 798-5975

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 Gilmore's NPI number?

The NPI number for Kelly Gilmore is 1962697417. It was assigned to this individual provider in the NPPES registry on September 7, 2007.

Where is Kelly Gilmore located?

Kelly Gilmore practices at 6550 Fannin St Ste 2307, Houston, TX 77030. The listed phone number is (713) 790-9250.

What is Kelly Gilmore's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Kelly Gilmore enrolled in Medicare?

Yes. Kelly Gilmore 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 Gilmore accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 9 other insurers list Kelly Gilmore 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 Gilmore affiliated with any hospitals?

According to CMS data, Kelly Gilmore is affiliated with Hca Houston Healthcare Conroe.

When was this NPI record last updated?

The NPPES record for Kelly Gilmore was last updated on October 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.