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MR. MICHAEL SEAN KELLY NP NPI 1003206004

NPI Profile

NPI: 1003206004
Provider Name: MR. MICHAEL SEAN KELLY, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: ALLIANCE PSYCHIATRIC GROUP INC A MEDICAL CORPORATION

PECOS Registration: Yes

Address:
17601 17TH ST STE 120
TUSTIN, CA
ZIP 92780
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Phone: (714) 769-6090

MR. Michael Sean Kelly, NP is a psychiatric/mental health nurse practitioner in Tustin, CA with 6 years of experience. MR. Michael Sean Kelly, NP NPI is 1003206004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

17601 17TH ST STE 120
TUSTIN, CA
ZIP 92780-946
Phone: (714) 769-6090

The NPI 1003206004 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, 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.

  • Psychiatric diagnostic evaluation with medical services (HCPCS:90792)
  • Psychotherapy, 30 minutes with patient and/or family member (HCPCS:90833)

The enumeration date for this NPI number is 1/28/2015 and was last updated on 1/24/2019.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health95001913CALIFORNIAYes

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: 6/3/2020

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.