CAROLYN KELLY (D.P.M.) – Foot & Ankle Surgery Podiatrist, NPI 1619264041

CAROLYN KELLY (D.P.M.) is a healthcare provider. based in Bolingbrook, Illinois. specializing in PODIATRY. They hold the professional credentials D.P.M.. They hold a License No. 016005524 (IL). The NPI Number for CAROLYN KELLY (D.P.M.) is 1619264041

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
CAROLYN KELLY (D.P.M.)
NPI
1619264041
Phone
(630) 418-6601
Address
396 REMINGTON BLVD STE 370
Enumeration Date
6 July 2011
Last Update Date
12 August 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3126337292
Graduation Year
2011 (15 years ago)
PAC ID
0941424675
Group Practice PAC ID
2860398088
Professional Enrollment ID
I20140618002303
Address ID
IL606123714CH1901XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:14State licenses:3Digital endpointsOther names

1,038 PODIATRY in IL

Provider Addresses for CAROLYN KELLY (D.P.M.)

  • 396 REMINGTON BLVD STE 370

    BOLINGBROOK, IL 604404302

    Phone: (630) 418-6601

    Fax: (630) 312-2223

    Type: Mailing

  • 256 Tudor Court

    Bolingbrook, IL 604402056

    Phone: (630) 294-0810

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $426.

Total Amount is formed as General ($426) + Research ($0) + Ownership ($0) = $426.

Last reported payment date: 2024-05-15 • Largest payer in this snapshot: Stryker Corporation ($343).

Total Amount

$426

General + Research + Ownership

Payments

3

Total payment records

General Amount

$426

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-15

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2014-06-18

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
I20140618002303IPodiatryILTBD

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 minutes14395$0
11721Removal of fingernails or toenails, 6 or more nails3130$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2613$0
99214Established patient office or other outpatient visit, 30-39 minutes2516$0
99203New patient office or other outpatient visit, 30-44 minutes2121$0
View full utilization report →

Insurance plans in this area (ZIP 60440)

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Provider's Procedures

CAROLYN KELLY (D.P.M.) performs procedures in PODIATRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYIL11042Removal of skin and tissue first 20 sq cm or less4213
PODIATRYIL11056Removal of 2 to 4 thickened skin growths14183

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: 2860398088View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology)MA
-IL
-IL
O B S T E T R I C S/ G Y N E C O L O G YIL
-IL
-IL
-IL
A N E S T H E S I O L O G YIL
Physician AssistantIL

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Frequently asked questions

Where can patients find CAROLYN KELLY (D.P.M.)'s NPI?
You can confirm CAROLYN KELLY (D.P.M.) with NPI 1619264041; it appears in the national provider directory.
Is CAROLYN KELLY (D.P.M.) currently active in the NPI registry?
CMS-published data lists CAROLYN KELLY (D.P.M.) as an active registrant.
Can you summarize CAROLYN KELLY (D.P.M.)'s specialty in plain language?
Clinically, the directory lists CAROLYN KELLY (D.P.M.) with Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What location shows for CAROLYN KELLY (D.P.M.)?
We surface Bolingbrook, Illinois for CAROLYN KELLY (D.P.M.) based on available NPPES addresses.
Is CAROLYN KELLY (D.P.M.) a real provider?
This page reflects official NPPES data for NPI 1619264041. Always confirm identity and privileges with the practice and licensing boards.

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