Dr Russell Phelps Kelley Iv, MD in Dallas, TX

Dr Russell Phelps Kelley Iv, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Dallas, Texas. His current practice location is 2825 Oak Lawn Ave Unit 192749, Dallas, Texas. You can reach out to his office (for appointments etc.) via phone at (510) 689-9500.

Dr Russell Phelps Kelley Iv is licensed to practice in Massachusetts (license number 1018091) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1215375373.

Contact Information

	Dr Russell Phelps Kelley Iv, MD
	2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219-4688
	(510) 689-9500
	(877) 880-2039

Map and Direction

Physician's Profile

Full Name	Dr Russell Phelps Kelley Iv
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	2825 Oak Lawn Ave Unit 192749, Dallas, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215375373
Provider Enumeration Date: 06/11/2013
Last Update Date: 09/10/2024

Medicare PECOS Information:

PECOS PAC ID: 0749416519
Enrollment ID: I20180713000612

Medical Identifiers

Medical identifiers for Dr Russell Phelps Kelley Iv such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215375373	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	S3004 (Texas)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	A135999 (California)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	1018091 (Massachusetts)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Russell Phelps Kelley Iv allows following entities to bill medicare on his behalf.

Entity Name	University Of California Sfgh Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063487122 PECOS PAC ID: 5496668410 Enrollment ID: O20031106000503

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Russell Phelps Kelley Iv is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Russell Phelps Kelley Iv, MD 2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219-4688 Ph: (510) 683-9500	Dr Russell Phelps Kelley Iv, MD 2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219-4688 Ph: (510) 689-9500

Reviews and Comments

Radiology Doctors in Dallas, TX

Dr. Nhat-long Lam Pham, M.D., PH.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5801 Forest Park Rd, Dallas, TX 75390 Phone: 241-645-7615 Fax: 214-645-7624
Firouzeh Arjmandi, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5323 Harry Hines Blvd., Dallas, TX 75390 Phone: 214-645-3586
Dr. John Debevits Iv, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5323 Harry Hines Blvd, Dallas, TX 75390 Phone: 214-648-3928
Natalia Cabrera Almonte, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 5323 Harry Hines Blvd # E6112, Dallas, TX 75390 Phone: 214-648-2054
W Crysup Sory, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12700 Park Central Dr, Ste 430, Dallas, TX 75251 Phone: 972-239-8902 Fax: 972-661-2551
Jacqueline Tyra Caire, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5323 Harry Hines Boulevard, Dallas, TX 75390 Phone: 469-757-1000
Dr. Thomas Louis Borok, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 5004 Spyglass Drive, Dallas, TX 75287 Phone: 972-931-1073 Fax: 972-931-1073

Dr Russell Phelps Kelley Iv, MD - Medicare Radiology in Dallas, TX