KELLY LYNNE DODGE (M.D.) – Emergency Medicine Physician, NPI 1275701286

KELLY LYNNE DODGE (M.D.) is a healthcare provider. based in New haven, Connecticut. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 046275 (CT). The NPI Number for KELLY LYNNE DODGE (M.D.) is 1275701286

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
KELLY LYNNE DODGE (M.D.)
NPI
1275701286
Phone
(203) 737-2489
Address
464 CONGRESS AVE
Enumeration Date
12 February 2008
Last Update Date
6 August 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9497644624
Graduation Year
2004 (22 years ago)
PAC ID
5496813057
Group Practice PAC ID
9436692100
Professional Enrollment ID
I20161108001814
Address ID
CA926634162NE1XXXXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

839 EMERGENCY MEDICINE in CT

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Provider Addresses for KELLY LYNNE DODGE (M.D.)

  • 464, Congress Avenue, Upper Davenport and Congress Avenue Historic District, New Haven, New Haven County, Connecticut, 06519, United States

    SUITE 260

    NEW HAVEN, CT 065191361

    Phone: (203) 737-2489

    Fax: (203) 785-4580

    Type: Mailing

  • Yale New Haven Hospital, 20, York Street, Downtown, New Haven, New Haven County, Connecticut, 06510, United States

    NEW HAVEN, CT 065103220

    Phone: (203) 688-2259

    Fax: (203) 688-5599

    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: 2016-11-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161108001814IEmergency MedicineCATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making419413$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only258241$0
99291Critical care, first 30-74 minutes120120$0
99284Emergency department visit with moderate level of medical decision making7372$0
99283Emergency department visit with low level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 06519)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436692100View full group profile
NameSpecialtyState
Nurse PractitionerCA
Emergency MedicineLA
Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineOK
Family PracticeOK
Emergency Medicine, Sports MedicineCA
Emergency MedicineCA
Nurse PractitionerCA
Emergency MedicineCA

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Frequently asked questions

Is KELLY LYNNE DODGE (M.D.) listed with a National Provider Identifier?
Yes — KELLY LYNNE DODGE (M.D.) has NPI 1275701286 on file in the registry.
Is KELLY LYNNE DODGE (M.D.) still an active registrant?
KELLY LYNNE DODGE (M.D.) carries an active NPI according to the public dataset.
What area of care is associated with KELLY LYNNE DODGE (M.D.)?
KELLY LYNNE DODGE (M.D.)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Connecticut is KELLY LYNNE DODGE (M.D.) registered?
Use New Haven, Connecticut as the headline location for KELLY LYNNE DODGE (M.D.) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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