KATIE KELLEY (MD, MPH) – Addiction Medicine (Family Medicine) Physician, NPI 1043847510

KATIE KELLEY (MD, MPH) is a healthcare provider. based in Cleveland, Ohio. specializing in FAMILY PRACTICE. They hold the professional credentials MD, MPH. They hold a License No. 35.144090 (OH). The NPI Number for KATIE KELLEY (MD, MPH) is 1043847510

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KATIE KELLEY (MD, MPH)
NPI
1043847510
Phone
(216) 778-4486
Address
2500 METROHEALTH DR
Enumeration Date
25 March 2020
Last Update Date
26 September 2023

Doctor Profile

Medical School Name
NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
2167787800
Graduation Year
2020 (6 years ago)
PAC ID
4688096670
Group Practice PAC ID
8628982949
Professional Enrollment ID
I20230814002613
Address ID
OH441091900CL2500XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

4,431 FAMILY PRACTICE in OH

Provider Addresses for KATIE KELLEY (MD, MPH)

  • 2500 METROHEALTH DR

    CLEVELAND, OH 441091900

    Phone: (216) 778-4486

    Mailing address matches the actual address.

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: 2023-08-14

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
I20230814002613IFamily PracticeOHTBD

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 44109)

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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: 8628982949View full group profile
NameSpecialtyState
-OH
-OH
Plastic And Reconstructive Surgery, Maxillofacial SurgeryOH
Cardiovascular Disease (Cardiology)OH
Emergency MedicineIN
Nurse PractitionerOH
-OH
Cardiovascular Disease (Cardiology), Internal MedicineOH
-OH
-VA

Reviews

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Frequently asked questions

How is KATIE KELLEY (MD, MPH) identified in CMS data?
CMS-hosted NPPES data lists KATIE KELLEY (MD, MPH) with NPI 1043847510.
Does the file indicate KATIE KELLEY (MD, MPH) is practicing under active NPI?
Directory data currently reports KATIE KELLEY (MD, MPH) as active.
What is KATIE KELLEY (MD, MPH)'s primary classification?
Addiction Medicine (Family Medicine) Physician is the headline specialty for KATIE KELLEY (MD, MPH) here. Clinical services aligned with this taxonomy classification.
Does KATIE KELLEY (MD, MPH) list a practice location?
Patients near Cleveland, Ohio may find KATIE KELLEY (MD, MPH) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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