Lawrence J Kelly, MD | |
12361 W Bola Dr, Suite 100, Surprise, AZ 85378-9021 | |
(623) 584-5626 | |
(623) 584-8998 |
Full Name | Lawrence J Kelly |
---|---|
Gender | Male |
Speciality | Orthopedic Surgery |
Experience | 34 Years |
Location | 12361 W Bola Dr, Surprise, Arizona |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124014758 | NPI | - | NPPES |
5920416 | Other | AZ | AETNA |
P00188666 | Other | AZ | RAILROAD MEDICARE |
2036792 | Other | AZ | UNITED HEALTHCARE |
2Z1651 | Other | AZ | HEALTHNET |
1124014758 | Other | AZ | AHCCCS |
P0836100 | Other | AZ | BCBS OUT OF AREA |
514829 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 27172 (Arizona) | Primary |
207XX0005X | Orthopaedic Surgery - Sports Medicine | 35083 (Arizona) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Banner Boswell Medical Center | Sun city, AZ | Hospital |
Banner Del E. Webb Medical Center | Sun city west, AZ | Hospital |
Banner Estrella Medical Center | Phoenix, AZ | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Bhsm Rehabilitation Llc | 2062773138 | 1355 |
Banner Physician Specialists Arizona Llc | 6204002272 | 255 |
Entity Name | Banner Physician Specialists Arizona Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316228802 PECOS PAC ID: 6204002272 Enrollment ID: O20111222000509 |
Mailing Address | Practice Location Address |
---|---|
Lawrence J Kelly, MD 12361 W Bola Dr, Suite 100, Surprise, AZ 85378-9021 Ph: (623) 584-5626 | Lawrence J Kelly, MD 12361 W Bola Dr, Suite 100, Surprise, AZ 85378-9021 Ph: (623) 584-5626 |
David A Rand, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 14780 W Mountain View Blvd Ste 110, Surprise, AZ 85374 Phone: 623-374-7774 Fax: 855-420-6361 | |
Martin G Sterusky, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 12361 W Bola Dr, Suite100, Surprise, AZ 85378 Phone: 623-584-5626 Fax: 623-584-8998 | |
Robert C Waldrip, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 12361 W Bola Dr, Suite 100, Surprise, AZ 85378 Phone: 623-584-5626 Fax: 623-544-9122 |