MELISSA ILENE KELLY (FNP) – Family Nurse Practitioner, NPI 1235594177

MELISSA ILENE KELLY (FNP) is a healthcare provider. based in Idaho falls, Idaho. specializing in Family Nurse Practitioner. They hold the professional credentials FNP. They hold a License No. NP-1668A (ID). The NPI Number for MELISSA ILENE KELLY (FNP) is 1235594177

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MELISSA ILENE KELLY (FNP)
NPI
1235594177
Phone
(208) 552-7700
Address
3614 WASHINGTON PKWY
Enumeration Date
18 December 2015
Last Update Date
18 December 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085527700
Graduation Year
2015 (11 years ago)
PAC ID
6709181779
Group Practice PAC ID
1052480076
Professional Enrollment ID
I20160229003005
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for MELISSA ILENE KELLY (FNP)

  • 3614 WASHINGTON PKWY

    IDAHO FALLS, ID 834047573

    Phone: (208) 552-7700

    Fax: (208) 552-1786

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 105 Open Payments records for all available years, with a total value of $2,233.

Total Amount is formed as General ($2,233) + Research ($0) + Ownership ($0) = $2,233.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($831).

Total Amount

$2,233

General + Research + Ownership

Payments

105

Total payment records

General Amount

$2,233

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2016-02-29

PECOS data refreshed: 2026-06-15

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
I20160229003005INurse PractitionerIDTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes9166$0
99214Established patient office or other outpatient visit, 30-39 minutes7352$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month3411$0
36415Insertion of needle into vein for collection of blood sample3122$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count1817$0
View full utilization report →

Insurance plans in this area (ZIP 83404)

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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: 1052480076View full group profile
NameSpecialtyState
Physician AssistantID
-ID
Physical Therapist In Private PracticeID
Physician AssistantID
Physician AssistantID
-ID
Physical Therapist In Private PracticeWA
Family PracticeID
Physical Therapist In Private PracticeID
Physician AssistantID

Reviews

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Frequently asked questions

How is MELISSA ILENE KELLY (FNP) identified in CMS data?
CMS-hosted NPPES data lists MELISSA ILENE KELLY (FNP) with NPI 1235594177.
Is MELISSA ILENE KELLY (FNP) still practicing?
MELISSA ILENE KELLY (FNP) is currently listed as active in the public NPI registry.
What is MELISSA ILENE KELLY (FNP)'s specialty?
The listing groups MELISSA ILENE KELLY (FNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MELISSA ILENE KELLY (FNP) based?
MELISSA ILENE KELLY (FNP) is tied to Idaho Falls, Idaho in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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