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TAWAPHAN W KELLY DDS
NPI 1992189674
Dentist - General Practice in Abilene, TX

Active since July 13, 2015PECOS Enrolled
4754 S 14TH ST, ABILENE, TX 79605(325) 480-1524 Get Directions Write a Review

NPPES record last updated: April 19, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 19, 2017, Nov 16, 2016 (2 updates tracked since 2016).

About Tawaphan W Kelly Dds NPPES

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

TAWAPHAN W KELLY DDS (NPI 1992189674) is an individual general practice provider in Abilene, Texas, licensed in Texas (32776) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992189674
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameTAWAPHAN W KELLYCredential: DDS
Location Address4754 S 14TH STAbilene, TX 79605-4733
Mailing Address3773 Patriot Dr Apt 101Abilene, TX 79606-1843 · (402) 670-8963
Phone(325) 480-1524
Sole ProprietorNo
Enumeration DateJuly 13, 2015
Last NPPES UpdateApril 19, 20172 updates tracked since enumeration
✔ NPI 1992189674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 32776
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.
Also ListedDentistTaxonomy 122300000X · License 7214 (NE)
4754 S 14TH ST, Abilene, TX 79605
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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 Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tawaphan W Kelly Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Tawaphan Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Centro De Salud Familiar La Fe, Inc
395 mi
Federally Qualified Health Center (FQHC)
700 S OCHOA ST
El Paso, TX 79901
  • Reassigned Medicare billing, Texas enrollment
  • 41 clinicians in this Medicare group
NPI 1629040621 (915) 534-7979

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79605 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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 2

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

NORTH MESA DENTAL, PC
Dentist (General Practice)
4754 S 14TH ST
ABILENE, TX 79605
Taylor County (800) 920-9947
RICHARD P JOHNSEN DMD
Dentist (Orthodontics and Dentofacial Orthopedics)
4754 S 14TH ST
ABILENE, TX 79605
Taylor County (325) 777-0110

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 Tawaphan Kelly's NPI number?

The NPI number for Tawaphan Kelly is 1992189674. It was assigned to this individual provider in the NPPES registry on July 13, 2015.

Where is Tawaphan Kelly located?

Tawaphan Kelly practices at 4754 S 14th St, Abilene, TX 79605. The listed phone number is (325) 480-1524.

What is Tawaphan Kelly's specialty?

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

Is Tawaphan Kelly enrolled in Medicare?

Yes. Tawaphan Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tawaphan Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tawaphan Kelly reassigns Medicare benefits to Centro De Salud Familiar La Fe, Inc (El Paso, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tawaphan Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tawaphan Kelly 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 19 other insurers list Tawaphan Kelly 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 Tawaphan Kelly was last updated on April 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.