TIMOTHY KELLY (PA-C) – Physician Assistant, NPI 1750353710

TIMOTHY KELLY (PA-C) is a healthcare provider. based in Boston, Maine. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA-815 (ME). The NPI Number for TIMOTHY KELLY (PA-C) is 1750353710

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY KELLY (PA-C)
NPI
1750353710
Phone
(617) 569-5800
Address
10 Gove Street
Enumeration Date
3 February 2006
Last Update Date
21 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6175695800
Graduation Year
2003 (23 years ago)
PAC ID
4880765130
Group Practice PAC ID
6103814371
Professional Enrollment ID
I20260206001822
Address ID
MA021281920EA10XXXSTXX300
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

1,167 PHYSICIAN ASSISTANT in ME

Provider Addresses for TIMOTHY KELLY (PA-C)

  • 10 Gove Street

    Boston, ME 02132

    Phone: (617) 569-5800

    Fax: (617) 568-4756

    Type: Location

  • Central Maine Medical Center, 300, Main Street, Lewiston, Androscoggin County, Maine, 04240, United States

    LEWISTON, ME 042407027

    Phone: (207) 795-2641

    Fax: (207) 753-7201

    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: 2026-02-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20080614000049IPhysician AssistantMETBD
I20260206001822IPhysician AssistantMATBD

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 making5047$0
99283Emergency department visit with low level of medical decision making2525$0
View full utilization report →

Insurance plans in this area (ZIP 02132)

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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: 6103814371View full group profile
NameSpecialtyState
-MA
O B S T E T R I C S/ G Y N E C O L O G YMA
-MA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
-MA
Nurse PractitionerMA

Reviews

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Frequently asked questions

Can I verify TIMOTHY KELLY (PA-C) with an NPI only?
You can start verification with NPI 1750353710 for TIMOTHY KELLY (PA-C), then check state licensing separately.
Is TIMOTHY KELLY (PA-C) listed as active for patients and plans?
The listing shows TIMOTHY KELLY (PA-C) as active in the NPI system.
What healthcare role does TIMOTHY KELLY (PA-C) hold?
Scheduling teams often label TIMOTHY KELLY (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Does TIMOTHY KELLY (PA-C) list a practice location?
Patients near Boston, Maine may find TIMOTHY KELLY (PA-C) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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