JENNIFER MARIE KELLY (DPT) – Physical Therapist, NPI 1417931817

JENNIFER MARIE KELLY (DPT) is a healthcare provider. based in Bend, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 4483 (OR). The NPI Number for JENNIFER MARIE KELLY (DPT) is 1417931817

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER MARIE KELLY (DPT)
NPI
1417931817
Phone
(541) 389-4321
Address
55 NW WALL ST STE 100
Enumeration Date
30 November 2005
Last Update Date
7 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5413894321
Graduation Year
2002 (24 years ago)
PAC ID
9830197516
Group Practice PAC ID
9638200991
Professional Enrollment ID
I20161010000314
Address ID
OR977033200BE55XXXSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:20State licenses:3Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

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Provider Addresses for JENNIFER MARIE KELLY (DPT)

  • 100, Northwest Wall Street, Bend, Deschutes County, Oregon, 97703, United States

    BEND, OR 977033200

    Phone: (541) 389-4321

    Fax: (541) 389-4420

    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: 2016-10-10

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
I20161010000314IPhysical Therapist In Private PracticeORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities32462$0
97140Therapy procedure using manual technique, each 15 minutes25776$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes17763$0
97113Therapy procedure using water pool to exercises, each 15 minutes11223$0
97161Evaluation for physical therapy, typically 20 minutes3029$0
View full utilization report →

Insurance plans in this area (ZIP 97703)

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Provider's Procedures

JENNIFER MARIE KELLY (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYOR97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes52840

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: 9638200991View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMO
-OR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
C H I R O P R A C T I COR

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Frequently asked questions

Where can patients find JENNIFER MARIE KELLY (DPT)'s NPI?
You can confirm JENNIFER MARIE KELLY (DPT) with NPI 1417931817; it appears in the national provider directory.
Is JENNIFER MARIE KELLY (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does JENNIFER MARIE KELLY (DPT) work in?
You can think of JENNIFER MARIE KELLY (DPT) as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
What location shows for JENNIFER MARIE KELLY (DPT)?
We surface Bend, Oregon for JENNIFER MARIE KELLY (DPT) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.