DR. SCOTT W. KELLEY MD NPI 1700863685

NPI Information

NPI: 1700863685
Provider Name: DR. SCOTT W. KELLEY, MD
Classification: Pathology - 207ZD0900X
Entity Type: Individual

Specialization: Dermatopathology

PECOS Registration: Yes

Address:
12805 W BURLEIGH RD
SUITE 200
BROOKFIELD, WI
ZIP 53005
Phone: (262) 797-6434
Get Directions

DR. Scott W. Kelley, MD is a dermatopathology pathology in Brookfield, WI. The provider is a dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. DR. Scott W. Kelley, MD NPI is 1700863685. 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:

12805 W BURLEIGH RD
SUITE 200
BROOKFIELD, WI
ZIP 53005-111
Phone: (262) 797-6434
Fax: (262) 797-6429

The NPI 1700863685 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 enumeration date for this NPI number is 12/30/2005 and was last updated on 5/1/2015.

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
1	207ZP0101X	Pathology	Anatomic Pathology	36968	WISCONSIN	No
2	207ZD0900X	Pathology	Dermatopathology	36968	WISCONSIN	Yes

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
1	H08551	MEDICARE UPIN
2	132700009	MEDICARE PIN	WISCONSIN
3	0540955	MEDICAID	IOWA
4	32649200	MEDICAID	WISCONSIN
5	682300021	MEDICARE PIN	WISCONSIN
6	220033078	MEDICARE PIN	WISCONSIN
7	017600024	MEDICARE PIN	WISCONSIN
8	162450010	MEDICARE PIN	WISCONSIN
9	222950009	MEDICARE PIN	WISCONSIN

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

NPI Synchronization or Removal

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