KEITH MCNELLIS (MD) – Internal Medicine Physician, NPI 1003804907

KEITH MCNELLIS (MD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. MD422449 (PA). The NPI Number for KEITH MCNELLIS (MD) is 1003804907

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
KEITH MCNELLIS (MD)
NPI
1003804907
Phone
(215) 707-1622
Address
2450 W HUNTING PARK AVE
Enumeration Date
13 October 2005
Last Update Date
10 April 2018

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2157075030
Graduation Year
2000 (26 years ago)
PAC ID
3678479805
Group Practice PAC ID
0345588711
Professional Enrollment ID
I20031209000833
Address ID
PA191405103PH3401XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,962 INTERNAL MEDICINE in PA

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Provider Addresses for KEITH MCNELLIS (MD)

  • 2450, West Hunting Park Avenue, Tioga, Philadelphia, Philadelphia County, Pennsylvania, 19129, United States

    PHILADELPHIA, PA 191291302

    Phone: (215) 707-1622

    Fax: (215) 707-0943

    Type: Mailing

  • Temple University Hospital, 3401, North Broad Street, Philadelphia, Philadelphia County, Pennsylvania, 19140, United States

    PHILADELPHIA, PA 191405103

    Phone: (215) 707-1622

    Fax: (215) 707-0943

    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: 2003-12-09

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
I20031209000833IInternal MedicinePATBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes15954$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes5929$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2222$0
99239Hospital discharge day management, more than 30 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 19129)

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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: 0345588711View full group profile
NameSpecialtyState
Internal MedicinePA
A N E S T H E S I O L O G YPA
Pulmonary Disease, Critical Care (Intensivists), HospitalistPA
O B S T E T R I C S/ G Y N E C O L O G YPA
-PA
Pulmonary Disease, Critical Care (Intensivists)PA
General SurgeryPA
-PA
P A T H O L O G YPA
-PA

Reviews

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Frequently asked questions

Is KEITH MCNELLIS (MD) listed with a National Provider Identifier?
Yes — KEITH MCNELLIS (MD) has NPI 1003804907 on file in the registry.
Is there an active status for KEITH MCNELLIS (MD)?
For scheduling context, KEITH MCNELLIS (MD) is shown as active in the registry.
What area of care is associated with KEITH MCNELLIS (MD)?
KEITH MCNELLIS (MD)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with KEITH MCNELLIS (MD)?
Directory geography for KEITH MCNELLIS (MD) centers on Philadelphia, Pennsylvania.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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