DR. KELLY ANN SMITH (D.O.) – Emergency Medicine Physician, NPI 1104960400

DR. KELLY ANN SMITH (D.O.) is a healthcare provider. based in Aurora, Illinois. specializing in EMERGENCY MEDICINE, INTERNAL MEDICINE. They hold the professional credentials D.O.. They hold a License No. 036119988 (IL). The NPI Number for DR. KELLY ANN SMITH (D.O.) is 1104960400

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY ANN SMITH (D.O.)
NPI
1104960400
Phone
(630) 978-4810
Address
2000 OGDEN AVE
Enumeration Date
19 February 2007
Last Update Date
20 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6309786200
Graduation Year
2004 (22 years ago)
PAC ID
3072684893
Group Practice PAC ID
1850657180
Professional Enrollment ID
I20080620000429
Address ID
IL605047222AU2000XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,845 EMERGENCY MEDICINE in IL

Provider Addresses for DR. KELLY ANN SMITH (D.O.)

  • 2000 OGDEN AVE

    AURORA, IL 605047222

    Phone: (630) 978-4810

    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 1 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2023-04-18 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($96).

Total Amount

$96

General + Research + Ownership

Payments

1

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-18

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Intuitive Surgical, Inc.$96
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: 2008-06-20

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
I20080620000429IEmergency MedicineILTBD

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
99284Emergency department visit with moderate level of medical decision making5853$0
99285Emergency department visit with high level of medical decision making2928$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only2621$0
View full utilization report →

Insurance plans in this area (ZIP 60504)

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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: 1850657180View full group profile
NameSpecialtyState
Emergency MedicineIL
Emergency MedicinePA
-IL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is the registry number for DR. KELLY ANN SMITH (D.O.)?
The registry entry for DR. KELLY ANN SMITH (D.O.) shows NPI 1104960400.
Is DR. KELLY ANN SMITH (D.O.)'s NPI status active today?
Active status means DR. KELLY ANN SMITH (D.O.)'s NPI record is not deactivated in the public file.
What services align with DR. KELLY ANN SMITH (D.O.)'s listing?
DR. KELLY ANN SMITH (D.O.)'s public classification highlights Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to DR. KELLY ANN SMITH (D.O.)?
The directory associates DR. KELLY ANN SMITH (D.O.) with Aurora, Illinois. Check all listed addresses for suites or satellite offices.
Can I export DR. KELLY ANN SMITH (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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