TRACIE R KELLY (APRN) – Family Nurse Practitioner, NPI 1578197513

TRACIE R KELLY (APRN) is a healthcare provider. based in Mendota, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 277.004233 (IL). The NPI Number for TRACIE R KELLY (APRN) is 1578197513

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
TRACIE R KELLY (APRN)
NPI
1578197513
Phone
(815) 878-8847
Address
110 8TH ST
Enumeration Date
28 February 2020
Last Update Date
22 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3096835050
Graduation Year
2019 (7 years ago)
PAC ID
6103247580
Group Practice PAC ID
3678889789
Professional Enrollment ID
I20200611001029
Address ID
IL616157829PE8600X91XX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for TRACIE R KELLY (APRN)

  • 110 8TH ST

    MENDOTA, IL 613421846

    Phone: (815) 878-8847

    Type: Mailing

  • 1401 E 12TH ST

    MENDOTA, IL 613429216

    Phone: (815) 539-7461

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2020-06-11

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
I20200611001029INurse PractitionerILTBD

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 minutes211185$0
81002Urinalysis, manual test3328$0
99203New patient office or other outpatient visit, 30-44 minutes2525$0
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)2422$0
J7620Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme1717$0
View full utilization report →

Insurance plans in this area (ZIP 61342)

Loading plans...

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: 3678889789View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I cross-check TRACIE R KELLY (APRN) using NPI 1578197513?
NPI 1578197513 belongs to TRACIE R KELLY (APRN); compare other details if you need extra assurance.
Active or inactive — what applies to TRACIE R KELLY (APRN)?
You should see TRACIE R KELLY (APRN) as active in CMS-hosted NPPES data.
What clinical focus is listed for TRACIE R KELLY (APRN)?
At a glance, TRACIE R KELLY (APRN) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is TRACIE R KELLY (APRN) associated with Mendota?
Public fields place TRACIE R KELLY (APRN) around Mendota, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

Similar Providers

JONATHAN EDWARDS

Family Nurse Practitioner
1405 E 12TH ST
NPI: 1164820312

JOY PRECIADO

Family Nurse Practitioner
1405 E 12TH ST
NPI: 1306216098

COURTNEY HARLEY (ANP)

Nurse Practitioner
1401 E. 12th
NPI: 1003361049

SHARON JONES BURTLOW (FNP-BC)

Family Nurse Practitioner
Xpress Clinic Mendota, 1201, Meriden Street, Mendota, LaSalle County, Illinois, 61342, United States
NPI: 1497203376
Currency Court, Rochelle, Ogle County, Illinois, 61068, United States
NPI: 1225553803

DIANA M OLSEN (APN)

Family Nurse Practitioner
1300 DRESDEN DR
NPI: 1952897001
1404 Washington St
NPI: 1043862964

SUSAN J OLSEN (APRN FNP-C)

Family Nurse Practitioner
537 N 3850TH RD
NPI: 1508491663