BOBBE J. KELLEY (D.O.) – Psychiatry Physician, NPI 1205996170

BOBBE J. KELLEY (D.O.) is a healthcare provider. based in Wixom, Michigan. specializing in PSYCHIATRY, ADDICTION MEDICINE. They hold the professional credentials D.O.. They hold a License No. 5101007808 (MI). The NPI Number for BOBBE J. KELLEY (D.O.) is 1205996170

Main info

Female
40 Years Of Experience
Accepts Medicare Assignment
Name
BOBBE J. KELLEY (D.O.)
NPI
1205996170
Phone
(248) 973-3660
Address
49197 WIXOM TECH DR STE B
Enumeration Date
11 December 2006
Last Update Date
17 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2489733660
Graduation Year
1986 (40 years ago)
PAC ID
2466586912
Group Practice PAC ID
1850516758
Professional Enrollment ID
I20100819000007
Address ID
MI48393XXXXWIXXXXXXXXXX00
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 PSYCHIATRY in MI

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Provider Addresses for BOBBE J. KELLEY (D.O.)

  • 49197 WIXOM TECH DR STE B

    WIXOM, MI 483933572

    Phone: (248) 973-3660

    Fax: (866) 784-4409

    Type: Mailing

  • Henry Ford Hospital, 2799, West Grand Boulevard, New Center, Detroit, Wayne County, Michigan, 48202, United States

    DETROIT, MI 482022608

    Phone: (313) 916-2600

    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: 2010-08-19

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
I20100819000007IPsychiatryMITBD

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 48393)

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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: 1850516758View full group profile
NameSpecialtyState
D E R M A T O L O G YMI
Internal MedicineMI
Clinical Social WorkerMI
-MI
Physician AssistantFL
Preventive Medicine, Internal MedicineMI

Reviews

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Frequently asked questions

Can I cross-check BOBBE J. KELLEY (D.O.) using NPI 1205996170?
NPI 1205996170 belongs to BOBBE J. KELLEY (D.O.); compare other details if you need extra assurance.
Is BOBBE J. KELLEY (D.O.) still an active registrant?
BOBBE J. KELLEY (D.O.) carries an active NPI according to the public dataset.
How would a patient describe BOBBE J. KELLEY (D.O.)'s focus?
For BOBBE J. KELLEY (D.O.), the primary taxonomy reads as Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with BOBBE J. KELLEY (D.O.)?
Directory geography for BOBBE J. KELLEY (D.O.) centers on Wixom, Michigan.
When was this NPI issued?
Enumeration for BOBBE J. KELLEY (D.O.) is noted as December 11, 2006 where the registry provides it.

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