STEPHANIE ELAINE KELLY (D.O.) – Diagnostic Radiology Physician, NPI 1598721755
Diagnostic Radiology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
384 DIAGNOSTIC RADIOLOGY in OK
Provider Addresses for STEPHANIE ELAINE KELLY (D.O.)
5801 E 41st St
Tulsa, OK 741355618
Phone: (918) 743-8943
Fax: (918) 743-8552
Type: Location
5801 E 41ST ST
TULSA, OK 741355618
Phone: (918) 743-8943
Fax: (918) 743-8552
Type: Mailing
DEPARTMENT 960591
OKLAHOMA CITY, OK 731960591
Phone: (800) 637-8884
Fax: (484) 224-2926
Type: Mailing
3300 NW EXPRESSWAY
OKLAHOMA CITY, OK 731124418
Phone: (405) 949-3011
Type: Location
859 E. PALACE AVE
SANTA FE, NM 87501
Phone: (405) 630-6562
Fax: (405) 562-9242
Type: Mailing
East 56th Street South, Muskogee County, Oklahoma, 74403, United States
SUITE 206
OKLAHOMA CITY, OK 731124426
Phone: (405) 945-4710
Fax: (405) 562-9242
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: 2022-02-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040824001089 | I | Diagnostic Radiology | OK | TBD |
| I20220222000868 | I | Diagnostic Radiology | NM | 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 |
|---|---|---|---|---|
| 77063 | Screening 3d breast mammography | 333 | 333 | $0 |
| 77067 | Screening mammography | 331 | 331 | $0 |
| 77065 | Diagnostic mammography of 1 breast | 55 | 52 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 49 | 49 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 41 | 40 | $0 |
Insurance plans in this area (ZIP 74135)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OK | |
| Diagnostic Radiology | WI | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology | OK | |
| General Practice | NY | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology, Interventional Radiology | NY | |
| Diagnostic Radiology | NJ | |
| Diagnostic Radiology | PA |
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