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DR. MARK KIM KELLY M.D NPI 1639300932


NPI Information

NPI: 1639300932
Provider Name: DR. MARK KIM KELLY, M.D
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
3707 NEW VISION DR
FORT WAYNE, IN
ZIP 46845
Phone: (248) 787-4905
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DR. Mark Kim Kelly, M.D is a diagnostic radiology radiology in Fort Wayne, IN with 15 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Mark Kim Kelly, M.D NPI is 1639300932. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2009

The provider's business location address is:

3707 NEW VISION DR
FORT WAYNE, IN
ZIP 46845-702
Phone: (248) 787-4905

The NPI 1639300932 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of chest, 1 view (HCPCS:71045)
  • Ct scan head or brain (HCPCS:70450)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Ct scan chest (HCPCS:71250)
  • Ct scan of abdomen and pelvis (HCPCS:74176)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • X-ray of hip with pelvis, 2-3 views (HCPCS:73502)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • X-ray of knee, 3 views (HCPCS:73562)
  • Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • X-ray of hand, minimum of 3 views (HCPCS:73130)
  • Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • Ultrasound of head and neck (HCPCS:76536)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • Ct scan of face (HCPCS:70486)
  • Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • Ultrasound pelvis through vagina (HCPCS:76830)
  • Bone and/or joint imaging, whole body (HCPCS:78306)

The enumeration date for this NPI number is 8/4/2009 and was last updated on 1/27/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic Radiology4301095025MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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