DR. EDWARD W KELLY (M.D.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1871541672
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
819 ORTHOPEDIC SURGERY in MN
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Provider Addresses for DR. EDWARD W KELLY (M.D.)
Koch Industries, Inc. | Lehigh Consumer Group, LLC, 4200, Dahlberg Drive, Glenwood Junction, Golden Valley, Hennepin County, Minnesota, 55422, United States
SUITE 300
GOLDEN VALLEY, MN 554224840
Phone: (952) 512-5600
Fax: (952) 512-5651
Type: Mailing
1000, 140th Street West, Burnsville, Dakota County, Minnesota, 55337, United States
SUITE 201
BURNSVILLE, MN 553374480
Phone: (952) 898-6300
Fax: (952) 898-6035
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $2,289.
Total Amount is formed as General ($2,289) + Research ($0) + Ownership ($0) = $2,289.
Last reported payment date: 2024-10-18 • Largest payer in this snapshot: EXACTECH, INC. ($2,122).
Total Amount
$2,289
General + Research + Ownership
Payments
12
Total payment records
General Amount
$2,289
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
2
Ownership records
Last Payment Date
2024-10-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| EXACTECH, INC. | $2,122 |
| Smith+Nephew, Inc. | $98 |
| Foundation Medical, Llc | $48 |
| Stryker Corporation | $21 |
| Responsive Arthroscopy Inc | $0 |
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: 2009-06-08
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090608000494 | I | Orthopedic Surgery | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 200 | 21 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 188 | 69 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 156 | 108 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 146 | 115 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 82 | 70 | $0 |
Insurance plans in this area (ZIP 55422)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Orthopedic Surgery | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | TX |
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