TIMOTHY KELLEY (M.D.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1790148245

TIMOTHY KELLEY (M.D.) is a healthcare provider. based in Worcester, Massachusetts. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials M.D.. They hold a License No. 042.0016062 (VT). The NPI Number for TIMOTHY KELLEY (M.D.) is 1790148245

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY KELLEY (M.D.)
NPI
1790148245
Phone
(508) 334-1000
Address
55 LAKE AVE N
Enumeration Date
1 April 2016
Last Update Date
20 September 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Secondary Phone
8022518611
Graduation Year
2021 (5 years ago)
PAC ID
7719270982
Group Practice PAC ID
9335112929
Professional Enrollment ID
I20221014000440
Address ID
VT053017601BR17XXXAVEX311
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

948 ORTHOPEDIC SURGERY in MA

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Provider Addresses for TIMOTHY KELLEY (M.D.)

  • UMASS Memorial Medical Center University Campus Hospital, 55, Lake Avenue North, Worcester, Worcester County, Massachusetts, 01653, United States

    WORCESTER, MA 016550002

    Phone: (508) 334-1000

    Type: Mailing

  • 17 BELMONT AVE

    BRATTLEBORO, VT 053017601

    Phone: (802) 251-8611

    Type: Mailing

  • 17 BELMONT AVE STE 1

    BRATTLEBORO, VT 053013498

    Phone: (025) 251-8611

    Fax: (802) 251-8419

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-04-22 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($24).

Total Amount

$39

General + Research + Ownership

Payments

2

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-22

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: 2022-10-14

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
I20221014000440IOrthopedic SurgeryVTTBD

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 minutes243148$0
99203New patient office or other outpatient visit, 30-44 minutes133133$0
20610Aspiration and/or injection of fluid from large joint8258$0
99214Established patient office or other outpatient visit, 30-39 minutes6759$0
99204New patient office or other outpatient visit, 45-59 minutes2525$0
View full utilization report →

Insurance plans in this area (ZIP 01655)

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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: 9335112929View full group profile

Reviews

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Frequently asked questions

What is the registry number for TIMOTHY KELLEY (M.D.)?
The registry entry for TIMOTHY KELLEY (M.D.) shows NPI 1790148245.
Is TIMOTHY KELLEY (M.D.)'s NPI status active today?
Active status means TIMOTHY KELLEY (M.D.)'s NPI record is not deactivated in the public file.
How should patients interpret TIMOTHY KELLEY (M.D.)'s specialty?
The extract shows Sports Medicine (Orthopaedic Surgery) Physician for TIMOTHY KELLEY (M.D.). Clinical services aligned with this taxonomy classification.
What city is tied to TIMOTHY KELLEY (M.D.)?
The directory associates TIMOTHY KELLEY (M.D.) with Worcester, Massachusetts. Check all listed addresses for suites or satellite offices.
Why is information missing for TIMOTHY KELLEY (M.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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