EVAN KELLY MD NPI 1124478458

NPI Information

NPI: 1124478458
Provider Name: EVAN KELLY, MD
Classification: Surgery - 208600000X
Entity Type: Individual
PECOS Registration: Yes
Address: 320 EAST MAIN ST
CROSBY, MN
ZIP 56441
Phone: (218) 546-7000

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NPI Details

Evan Kelly, MD is a surgery in Crosby, MN with 10 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Evan Kelly, MD NPI is 1124478458. 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:

320 EAST MAIN ST
CROSBY, MN
ZIP 56441
Phone: (218) 546-7000
Fax: (218) 546-4400

The NPI 1124478458 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.

Colonoscopy (HCPCS:NAN13)
Hernia repair (minimally invasive) (HCPCS:NAN16)
Pacemaker insertion or repair (HCPCS:NAN10)
Upper gastrointestinal (GI) endoscopy for acid reflux (HCPCS:NAN12)

The enumeration date for this NPI number is 6/17/2016 and was last updated on 11/6/2025.

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	License Number	License State	Primary
1	208600000X	Surgery	56579	KENTUCKY	No
2	390200000X	Student in an Organized Health Care Education/Training Program	TP 00013351	COLORADO	No
3	208600000X	Surgery	69041	MINNESOTA	Yes

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: 11/21/2025

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