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MR. KELLY L. MCDONALD PA
NPI 1972516359
Physician Assistant in Estancia, NM

Active since August 15, 2006PECOS EnrolledAccepts Medicare Assignment
80.33/100
CMS Quality Rating
903 5TH ST # C, ESTANCIA, NM 87016(505) 384-2777 Get Directions Write a Review

NPPES record last updated: September 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kelly L. Mcdonald Pa NPPES

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

MR. KELLY L. MCDONALD PA (NPI 1972516359) is an individual physician assistant in Estancia, New Mexico, licensed in New Mexico (PA2013-0057) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1972516359
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KELLY L. MCDONALDCredential: PA
Location Address903 5TH ST # CEstancia, NM 87016-1155
Mailing Address903 5th St # CEstancia, NM 87016-1155 · (505) 384-2777 · Fax (505) 384-2204
Phone(505) 384-2777
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 15, 2006
Last NPPES UpdateSeptember 8, 2023
NPPES CertifiedSeptember 8, 2023
✔ NPI 1972516359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NM · PA2013-0057
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License 237 (NM)
903 5TH ST # C, Estancia, NM 87016
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma.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

Mr. Kelly L. Mcdonald Pa 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 ID8729215694
PECOS Enrollment IDI20131220001763
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

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
92 services50 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87016 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.

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.

80.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality61.79
Promoting Interoperability100
Improvement Activities40
Cost72.64

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers26 claims26 services$79.75 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
4 suppliers18 claims18 services$35.30 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ANDREW THOMAS THEUS PA-C
Physician Assistant
903 5TH ST # C
ESTANCIA, NM 87016
Torrance County (505) 384-2777
ALYSON DEAKYNE LCSW
Social Worker (Clinical)
903 5TH ST # C
ESTANCIA, NM 87016
Torrance County (505) 384-2777

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 Mcdonald's NPI number?

The NPI number for Kelly Mcdonald is 1972516359. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Where is Kelly Mcdonald located?

Kelly Mcdonald practices at 903 5th St # C, Estancia, NM 87016. The listed phone number is (505) 384-2777.

What is Kelly Mcdonald's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kelly Mcdonald enrolled in Medicare?

Yes. Kelly Mcdonald 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 Mcdonald accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Kelly Mcdonald 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.

When was this NPI record last updated?

The NPPES record for Kelly Mcdonald was last updated on September 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.