Joseph P Kelly, DO is a medicare enrolled "Orthopaedic Surgery" physician in New Berlin, Wisconsin. His current practice location is
12555 W National Ave Ste 100, New Berlin, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 395-4141.
Joseph P Kelly is licensed to practice in Wisconsin (license number 81454-21) 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 1164917779.
Physician's Profile
Full Name | Joseph P Kelly |
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Gender | Male |
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Speciality | Orthopaedic Surgery |
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Location | 12555 W National Ave Ste 100, New Berlin, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164917779
- Provider Enumeration Date: 06/26/2018
- Last Update Date: 01/14/2025
Medicare PECOS Information:
- PECOS PAC ID: 5092173773
- Enrollment ID: I20230628002028
Medical Identifiers
Medical identifiers for Joseph P Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164917779 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207X00000X | Orthopaedic Surgery | O-1746 (Idaho) | Secondary |
207X00000X | Orthopaedic Surgery | 81454-21 (Wisconsin) | 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. Joseph P Kelly allows following entities to bill medicare on his behalf.
Entity Name | Boise Shoulder Clinic, Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760581409 PECOS PAC ID: 4688671621 Enrollment ID: O20061103000362 |
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Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
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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. Joseph P Kelly 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 |
Joseph P Kelly, DO 12555 W National Ave Ste 100, New Berlin, WI 53151-4061 Ph: (262) 395-4141 | Joseph P Kelly, DO 12555 W National Ave Ste 100, New Berlin, WI 53151-4061 Ph: (262) 395-4141 |
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