David Allen Kelly Jr, CRNP - Medicare Nurse Practitioner in Portland, OR

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David Allen Kelly Jr, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Oregon. His current practice location is 3303 S Bond Ave, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 494-6346.

David Allen Kelly Jr is licensed to practice in Oregon (license number 202207583NP-PP) 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 1639930779.

Contact Information

David Allen Kelly Jr, CRNP
3303 S Bond Ave,
Portland, OR 97239-4501
(503) 494-6346
(503) 494-5385

Map and Direction




Provider's Profile

Full NameDavid Allen Kelly Jr
GenderMale
SpecialityNurse Practitioner - Family
Location3303 S Bond Ave, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639930779
  • Provider Enumeration Date: 01/16/2024
  • Last Update Date: 05/07/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9830539576
  • Enrollment ID: I20240429003197

Medical Identifiers

Medical identifiers for David Allen Kelly Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639930779NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 202207583NP-PP (Oregon)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. David Allen Kelly Jr allows following entities to bill medicare on his behalf.
Entity NameUniversity Professional Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376709535
PECOS PAC ID: 4880760107
Enrollment ID: O20080910000013

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. David Allen Kelly Jr 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 AddressPractice Location Address
David Allen Kelly Jr, CRNP
1400 Sw 5th Ave Ste 500,
Portland, OR 97201-5537

Ph: (866) 617-6855		David Allen Kelly Jr, CRNP
3303 S Bond Ave,
Portland, OR 97239-4501

Ph: (503) 494-6346

Reviews and Comments


Nurse Practitioner Nurses in Portland, OR

Mrs. Anjalee Nix Rowe, NP
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Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239
Phone: 503-494-3988    
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Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239
Phone: 971-202-5500    Fax: 971-202-5555
Iva Juric,
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Phone: 503-494-4808    
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Practice Location: 3550 N Interstate Ave, Portland, OR 97227
Phone: 503-746-1575    
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Phone: 503-525-0090    
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Practice Location: 1834 Nw 25th Ave Apt 504, Portland, OR 97210
Phone: 971-354-9242    
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Medicare: Medicare Enrolled
Practice Location: 12121 E Burnside St, Portland, OR 97216
Phone: 971-361-7700    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.