EDWARD LESLIE KELLY (MD) – Forensic Psychiatry Physician, NPI 1013995471
Forensic Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
256 PSYCHIATRY in UT
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Provider Addresses for EDWARD LESLIE KELLY (MD)
East Center Street, Riverbottoms, Provo, Utah County, Utah, 84604, United States
PROVO, UT 846063554
Phone: (801) 344-4400
Fax: (801) 344-4225
Type: Location
PO BOX 270
PROVO, UT 846030270
Phone: (801) 344-4400
Fax: (801) 344-4225
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $56.
Total Amount is formed as General ($56) + Research ($0) + Ownership ($0) = $56.
Last reported payment date: 2024-05-03 • Largest payer in this snapshot: Stryker Corporation ($56).
Total Amount
$56
General + Research + Ownership
Payments
1
Total payment records
General Amount
$56
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $56 |
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: 2019-05-08
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 |
|---|---|---|---|---|
| I20140814002120 | I | Psychiatry | MN | TBD |
| I20190508001230 | I | Psychiatry | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84606)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | UT | |
| - | UT | |
| - | UT | |
| P S Y C H I A T R Y | VA | |
| - | UT | |
| - | UT | |
| Clinical Social Worker | UT | |
| Clinical Social Worker | UT | |
| - | UT | |
| - | UT |
Reviews
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