KELLY T CLOUSE (MD) – Psychiatry Physician, NPI 1932104288

KELLY T CLOUSE (MD) is a healthcare provider. based in St augustine, Florida. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 46974 (WI). The NPI Number for KELLY T CLOUSE (MD) is 1932104288

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
KELLY T CLOUSE (MD)
NPI
1932104288
Phone
(904) 823-2896
Address
100 DEERFIELD PRESERVE BLVD
Enumeration Date
14 June 2005
Last Update Date
28 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
9042139210
Graduation Year
2000 (26 years ago)
PAC ID
4880663947
Group Practice PAC ID
8820003411
Professional Enrollment ID
I20120711000150
Address ID
FL320734461OR2021XDRXX402
Telehealth
Yes

Contacts

Secure Messaging
KELLY.CLOUSE@hca5.eclinicaldirectplus.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness95
Years active:20State licenses:2Other names

1,953 PSYCHIATRY in FL

Provider Addresses for KELLY T CLOUSE (MD)

  • 100 DEERFIELD PRESERVE BLVD

    ST AUGUSTINE, FL 320865966

    Phone: (904) 823-2896

    Type: Mailing

  • 2021 PROFESSIONAL CENTER DR STE 101

    ORANGE PARK, FL 320734461

    Phone: (904) 213-9210

    Fax: (904) 213-9211

    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: 2012-07-11

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
I20120711000150IPsychiatryFLTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes13532$0
View full utilization report →

Insurance plans in this area (ZIP 32086)

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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: 8820003411View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
-FL
General SurgeryOH
Family PracticeFL
-FL
Nurse PractitionerFL
-FL
-FL
Infectious Disease, Internal MedicineFL

Reviews

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Frequently asked questions

Where can patients find KELLY T CLOUSE (MD)'s NPI?
You can confirm KELLY T CLOUSE (MD) with NPI 1932104288; it appears in the national provider directory.
Is KELLY T CLOUSE (MD)'s NPI currently valid?
The extract we use shows KELLY T CLOUSE (MD) as active.
What kind of provider is KELLY T CLOUSE (MD)?
The page reflects Psychiatry Physician for KELLY T CLOUSE (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for KELLY T CLOUSE (MD)?
The page summarizes St Augustine, Florida for KELLY T CLOUSE (MD); expand the address list for detail.
Is KELLY T CLOUSE (MD) a real provider?
This page reflects official NPPES data for NPI 1932104288. Always confirm identity and privileges with the practice and licensing boards.

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