RYAN JAMES KELLY – Clinical Social Worker, NPI 1013590272

RYAN JAMES KELLY is a healthcare provider. based in Ontario, Oregon. specializing in CLINICAL SOCIAL WORKER. The NPI Number for RYAN JAMES KELLY is 1013590272

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
RYAN JAMES KELLY
NPI
1013590272
Phone
(541) 889-9176
Address
702 SUNSET DR
Enumeration Date
4 May 2021
Last Update Date
4 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5418899167
Graduation Year
2022 (4 years ago)
PAC ID
9234636622
Group Practice PAC ID
4183696214
Professional Enrollment ID
I20251010001108
Address ID
OR979143121ON702XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:5State licenses:0Digital endpointsOther names

1,405 CLINICAL SOCIAL WORKER in OR

Provider Addresses for RYAN JAMES KELLY

  • 702 SUNSET DR

    ONTARIO, OR 979143121

    Phone: (541) 889-9176

    Fax: (541) 889-7873

    Type: Location

  • 1030 E Fleetwood Ct

    Boise, ID 837065176

    Phone: (208) 777-5122

    Fax: (208) 777-5122

    Type: Location

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: 2025-10-10

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
I20251010001108IClinical Social WorkerORTBD

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 97914)

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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: 4183696214View full group profile
NameSpecialtyState
Mental Health CounselorOR
-ID
Clinical Social WorkerOR
Undefined Non Physician Type (Specify)OR
Clinical Social WorkerOR
-ID
-ID
-OH
Clinical Social WorkerOR
Undefined Non Physician Type (Specify)OR

Reviews

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Frequently asked questions

How do I look up RYAN JAMES KELLY by NPI?
Use NPI 1013590272 when you need to reference RYAN JAMES KELLY in forms, claims, or directories.
Is RYAN JAMES KELLY currently active in the NPI registry?
CMS-published data lists RYAN JAMES KELLY as an active registrant.
What does RYAN JAMES KELLY treat or focus on?
Patients typically see RYAN JAMES KELLY under the specialty Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does RYAN JAMES KELLY practice in Oregon?
You will see Ontario, Oregon on file for RYAN JAMES KELLY alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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