Mark Joseph Kelly (NPI# 1093889263, PAC ID# 8628101599) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1093889263 |
| PAC ID by PECOS | 8628101599 |
| Professional Enrollment ID | I20100728001028 |
| Full Name | Mark Joseph Kelly |
| Address |
2811 Wilshire Blvd Suite 810 Santa Monica CA 90403-4812 |
| Gender | M |
| Medical School | ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY |
| Graduation Year | 1984 |
| Primary Specialty | UROLOGY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050290 | PROVIDENCE SAINT JOHN'S HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2811 Wilshire Blvd, Suite 810, Santa Monica, CA 90403-4812 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_431_overall | Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 100% |
| Street Address |
2811 WILSHIRE BLVD SUITE 810 |
| City | SANTA MONICA |
| State | CA |
| Zip | 90403-4812 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deven Khosla | Neurosurgery | Achieve Brain and Spine Inc | 2811 Wilshire Blvd, Suite 930, Santa Monica, CA 90403-4803 |
| Martin L Alpert | Family Medicine | Martin L. Alpert, M.d., Inc. | 2811 Wilshire Blvd, Suite 810, Santa Monica, CA 90403-4812 |
| Tanya Kormeili | Dermatology | 2811 Wilshire Blvd, Suite 640, Santa Monica, CA 90403-4823 | |
| Peter M Birnstein | Family Medicine | 2811 Wilshire Blvd, Suite 800, Santa Monica, CA 90403-4808 | |
| David R Allen | Family Medicine | 2811 Wilshire Blvd, Suite 800, Santa Monica, CA 90403-4808 | |
| Ronald J Hale | Dermatology | Martin L. Alpert, M.d., Inc. | 2811 Wilshire Blvd, Suite 810, Santa Monica, CA 90403-4812 |
| Douglas Tyler | Internal Medicine | 2811 Wilshire Blvd, Suite 800, Santa Monica, CA 90403-4870 | |
| Sant P Chawla | Hematology/oncology | Sant P. Chawla M.d. Inc. | 2811 Wilshire Blvd, Suite 414, Santa Monica, CA 90403-4804 |
| Hyun W Bae | Orthopedic Surgery | Hyun Bae Md A Professional Corp | 2811 Wilshire Blvd, Suite 850, Santa Monica, CA 90403-4812 |
| Daniel Thomas Franc | Neurology | 2811 Wilshire Blvd, Suite 800, Santa Monica, CA 90403-4808 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Curtis Dickey | Optometry | 901 Montana Ave, Santa Monica, CA 90403-1537 | |
| Phillip Herel | Physical Therapy | 1301 Montana Ave, Suite A, Santa Monica, CA 90403-1767 | |
| Patrick D Edgecomb | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Christopher Scott Dahl | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Nicola N Nakase | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Rashmi Bandekar | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Marc A Hara | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Minchul Jung | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Jennifer M Esquer | Physical Therapy | Vert Westside LLC | 3011 Wilshire Blvd, Santa Monica, CA 90403-2301 |
| Bijan Cohenmehr | Optometry | 3116 Wilshire Blvd, Santa Monica, CA 90403-2304 | |
| Find all physicians in zip 90403 | |||
| City | SANTA MONICA |
| Zip Code | 90403 |
| Specialty | UROLOGY |
| City + Specialty | SANTA MONICA + UROLOGY |
Please comment or provide details below to improve the information on Mark Joseph Kelly.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.