DR. KELLY TAY LOCKE (MD) – Family Medicine Physician, NPI 1376546002
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
495 FAMILY PRACTICE in AK
Provider Addresses for DR. KELLY TAY LOCKE (MD)
3100 Tongass Ave
Ketchikan, AK 999015746
Phone: (907) 228-8300
Fax: (907) 228-8440
Type: Location
401 CASTLE CREEK RD
ASPEN, CO 816111159
Phone: (970) 279-4111
Fax: (970) 927-3915
Type: Mailing
East Valley Road, Basalt, Eagle County, Colorado, 61621, United States
BASALT, CO 816218412
Phone: (970) 279-4111
Fax: (970) 927-3915
Type: Mailing
1460 E Valley Rd Ste 103
Basalt, CO 816218412
Phone: (970) 279-4111
Fax: (970) 927-3915
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-12-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040818000560 | I | Family Practice | CO | TBD |
| I20231101000848 | I | Family Practice | AK | TBD |
| I20231224000066 | I | Family Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 121 | 82 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 44 | 44 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 39 | 33 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 31 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 16 | 16 | $0 |
Insurance plans in this area (ZIP 99901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | SC | |
| - | TX | |
| - | AK | |
| Mental Health Counselor | AK | |
| - | WA | |
| - | WA | |
| Internal Medicine, Geriatric Medicine | AK | |
| - | AK | |
| Nurse Practitioner | FL | |
| - | FL |
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