MICHAELA J CLARK-KELLEY (DO) – Family Medicine Physician, NPI 1306837620

MICHAELA J CLARK-KELLEY (DO) is a healthcare provider. based in Waterville, Maine. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 1802 (ME). The NPI Number for MICHAELA J CLARK-KELLEY (DO) is 1306837620

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MICHAELA J CLARK-KELLEY (DO)
NPI
1306837620
Phone
(207) 873-3753
Address
180 KENNEDY MEMORIAL DR
Enumeration Date
4 November 2005
Last Update Date
12 August 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Secondary Phone
2076218880
Graduation Year
2002 (24 years ago)
PAC ID
5092743864
Group Practice PAC ID
1254245715
Professional Enrollment ID
I20050802000864
Address ID
ME043300000AU15XXXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

886 FAMILY PRACTICE in ME

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Provider Addresses for MICHAELA J CLARK-KELLEY (DO)

  • 180, Kennedy Memorial Drive, Waterville, Kennebec County, Maine, 04901, United States

    SUITE 301

    WATERVILLE, ME 049014540

    Phone: (207) 873-3753

    Fax: (207) 873-2620

    Type: Mailing

  • 15 ENTERPRISE DR

    AUGUSTA, ME 043307997

    Phone: (207) 621-8800

    Fax: (207) 621-8801

    Type: Mailing

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: 2005-08-02

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
I20050802000864IFamily PracticeMETBD

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
99214Established patient office or other outpatient visit, 30-39 minutes13284$0
99213Established patient office or other outpatient visit, 20-29 minutes8132$0
98928Osteopathic manipulative treatment, 7-8 body regions7212$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit4646$0
View full utilization report →

Insurance plans in this area (ZIP 04901)

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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: 1254245715View full group profile

Reviews

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Frequently asked questions

Does MICHAELA J CLARK-KELLEY (DO) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MICHAELA J CLARK-KELLEY (DO) uses 1306837620.
Does the file indicate MICHAELA J CLARK-KELLEY (DO) is practicing under active NPI?
Directory data currently reports MICHAELA J CLARK-KELLEY (DO) as active.
What is MICHAELA J CLARK-KELLEY (DO)'s specialty?
The listing groups MICHAELA J CLARK-KELLEY (DO) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does MICHAELA J CLARK-KELLEY (DO) serve?
MICHAELA J CLARK-KELLEY (DO)'s listing highlights Waterville, Maine; more addresses can appear in NPPES.
Is the information about MICHAELA J CLARK-KELLEY (DO) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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