MICHAEL TIMOTHY KELLEY M.S. PA-C NPI 1073571816

NPI Information

  • NPI: 1073571816
  • Provider Name: MICHAEL TIMOTHY KELLEY, M.S. PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6625 S RURAL RD STE 104
    TEMPE, AZ
    ZIP 85283
  • Phone: (480) 833-4515

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NPI Details

Michael Timothy Kelley, M.S. PA-C is a surgical physician assistant in Tempe, AZ. Michael Timothy Kelley, M.S. PA-C NPI is 1073571816. 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:

6625 S RURAL RD STE 104
TEMPE, AZ
ZIP 85283-717
Phone: (480) 833-4515
Fax: (480) 833-5078

The NPI 1073571816 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.

  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Fluoroscopic guidance for needle placement (HCPCS:77002)
  • Injection of trigger points, 3 or more muscles (HCPCS:20553)
  • Complete ultrasound scan of joint (HCPCS:76881)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 5/2/2006 and was last updated on 8/8/2023.

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
1363AS0400XPhysician AssistantSurgicalNo
2363AS0400XPhysician AssistantSurgicalAZ3829ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AZ3829OTHERARIZONAARIZONA STATE LICENSE NUMBER
2585950MEDICAIDARIZONA

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: 3/30/2025

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