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DR. JOSEPH T. KELLY SR. D.M.D.
NPI 1972945509
Dentist in Clarks Summit, PA

Active since July 24, 2013Opted out of Medicare · through Apr 26, 2028
103 W GROVE ST, CLARKS SUMMIT, PA 18411(570) 587-4787(570) 586-2375 Get Directions Write a Review

NPPES record last updated: July 24, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Joseph T. Kelly Sr. D.m.d. NPPES

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

DR. JOSEPH T. KELLY SR. D.M.D. (NPI 1972945509) is an individual dentist in Clarks Summit, Pennsylvania, licensed in Pennsylvania (DS017660L) and active in the NPI registry since July 2013. He has opted out of Medicare through April 26, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1972945509
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JOSEPH T. KELLY SR.Credential: D.M.D.
Location Address103 W GROVE STClarks Summit, PA 18411-2062
Mailing Address103 W Grove StClarks Summit, PA 18411-2062 · (570) 587-4787 · Fax (570) 586-2375
Phone(570) 587-4787
Fax(570) 586-2375
Sole ProprietorNo
Enumeration DateJuly 24, 2013
✔ NPI 1972945509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in PA · DS017660L
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
103 W GROVE ST, Clarks Summit, PA 18411
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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. Joseph T. Kelly Sr. D.m.d. 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 April 26, 2016 through April 26, 2028.

Opt-Out Effective DateApril 26, 2016
Opt-Out In Effect ThroughApril 26, 2028Opt-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 18411 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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 3

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

DR. CAITLIN LIBBY DDS
Dentist (Prosthodontics)
103 W GROVE ST
CLARKS SUMMIT, PA 18411
Lackawanna County (570) 587-4787
DR. JOSEPH THOMAS MAJESKI M.D.
Dermatology
103 W GROVE ST
CLARKS SUMMIT, PA 18411
Lackawanna County (570) 586-7220
DR. JOSEPH T. KELLY JR. D.M.D.
Dentist (Prosthodontics)
103 W GROVE ST
CLARKS SUMMIT, PA 18411
Lackawanna County (570) 587-4787

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 Joseph Kelly's NPI number?

The NPI number for Joseph Kelly is 1972945509. It was assigned to this individual provider in the NPPES registry on July 24, 2013.

Where is Joseph Kelly located?

Joseph Kelly practices at 103 W Grove St, Clarks Summit, PA 18411. The listed phone number is (570) 587-4787.

What is Joseph Kelly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Joseph Kelly enrolled in Medicare?

No. Joseph Kelly has opted out of Medicare through April 26, 2028. 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 Joseph Kelly was last updated on July 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.