MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) – Registered Dietitian, NPI 1942010178

MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) is a healthcare provider. based in Glen ellyn, Illinois. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD, CDCES, NBC-HWC. They hold a License No. 164.005904 (IL). The NPI Number for MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) is 1942010178

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC)
NPI
1942010178
Phone
(617) 833-3783
Address
23W308 WESTCHESTER CT
Enumeration Date
9 January 2025
Last Update Date
9 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8134608792
Graduation Year
1999 (27 years ago)
PAC ID
7517440050
Group Practice PAC ID
8820469208
Professional Enrollment ID
I20260312000984
Address ID
FL337062524ST229XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL

Provider Addresses for MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC)

  • 23W308 WESTCHESTER CT

    GLEN ELLYN, IL 601376546

    Phone: (617) 833-3783

    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)

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: 2026-03-12

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
I20260312000984IRegistered Dietitian Or Nutrition ProfessionalFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60137)

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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: 8820469208View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalAZ
Registered Dietitian Or Nutrition ProfessionalIL
Registered Dietitian Or Nutrition ProfessionalTX

Reviews

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Frequently asked questions

Can I verify MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) with an NPI only?
You can start verification with NPI 1942010178 for MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC), then check state licensing separately.
Is MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) listed as active for patients and plans?
The listing shows MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) as active in the NPI system.
What is MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC)'s primary classification?
Registered Dietitian is the headline specialty for MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) here. Clinical services aligned with this taxonomy classification.
Where should I expect MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) on a map?
Expect Glen Ellyn, Illinois as a primary anchor for MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) unless the record lists multiple sites.
Is the information about MARISSA ELAINE KELLEY (RD, CDCES, NBC-HWC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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