DR. KELLY MAH (M.D.) – Obstetrics & Gynecology Physician, NPI 1053420489
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,008 OBSTETRICS/GYNECOLOGY in CA
Provider Addresses for DR. KELLY MAH (M.D.)
1191 E Yosemite Ave Ste C
Manteca, CA 953365071
Phone: (209) 824-2202
Fax: (209) 824-2205
Type: Location
421, East Center Street, Manteca, San Joaquin County, California, 95336, United States
MANTECA, CA 953364718
Phone: (209) 823-7616
Fax: (209) 823-4352
Type: Mailing
PO BOX 993
MANTECA, CA 953361139
Phone: (209) 612-9077
Type: Mailing
1205 E NORTH ST
MANTECA, CA 953364932
Phone: (209) 612-9077
Fax: (209) 824-0754
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $25.
Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.
Last reported payment date: 2024-05-11 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($25).
Total Amount
$25
General + Research + Ownership
Payments
1
Total payment records
General Amount
$25
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $25 |
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: 2021-03-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20210325002111 | I | Obstetrics/Gynecology | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95336)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| - | WA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Obstetrics/Gynecology, Family Practice | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NC | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| - | CA |
Reviews
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