KELLY A PHILLIPS (D.O.) – Emergency Medicine Physician, NPI 1003047796

KELLY A PHILLIPS (D.O.) is a healthcare provider. based in Lakewood, Washington. specializing in EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. 4759 (OK). The NPI Number for KELLY A PHILLIPS (D.O.) is 1003047796

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
KELLY A PHILLIPS (D.O.)
NPI
1003047796
Phone
(253) 985-8700
Address
11315 BRIDGEPORT WAY SW
Enumeration Date
29 July 2009
Last Update Date
9 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8177571500
Graduation Year
2008 (18 years ago)
PAC ID
4981734498
Group Practice PAC ID
0749447936
Professional Enrollment ID
I20181004000252
Address ID
TX760871191WI101XXBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:16State licenses:2Digital endpointsOther names

1,206 EMERGENCY MEDICINE in WA

Loading map...

Provider Addresses for KELLY A PHILLIPS (D.O.)

  • Saint Clare Hospital, 11315, Bridgeport Way Southwest, Tahitian Apartments, Lakeview, Lakewood, Pierce County, Washington, 98499, United States

    EMERGENCY DEPT

    LAKEWOOD, WA 984993004

    Phone: (253) 985-8700

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $98.

Total Amount is formed as General ($98) + Research ($0) + Ownership ($0) = $98.

Last reported payment date: 2023-10-12 • Largest payer in this snapshot: CSL Behring ($98).

Total Amount

$98

General + Research + Ownership

Payments

1

Total payment records

General Amount

$98

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-12

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CSL Behring$98
View all Open Payments →|Open Payments Risk Radar →

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: 2018-10-04

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100610000095IEmergency MedicineOKTBD
I20181004000252IEmergency MedicineTXTBD

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
99285Emergency department visit with high level of medical decision making158155$0
99284Emergency department visit with moderate level of medical decision making131129$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only5756$0
99283Emergency department visit with low level of medical decision making3333$0
99291Critical care, first 30-74 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 98499)

Loading plans...

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: 0749447936View full group profile
NameSpecialtyState
Physician AssistantTX
Physician AssistantTX
Emergency MedicineTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Emergency MedicineTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is KELLY A PHILLIPS (D.O.) listed with a National Provider Identifier?
Yes — KELLY A PHILLIPS (D.O.) has NPI 1003047796 on file in the registry.
Is KELLY A PHILLIPS (D.O.) shown as active in public data?
Registry records indicate KELLY A PHILLIPS (D.O.) maintains an active NPI.
What kind of doctor is KELLY A PHILLIPS (D.O.)?
KELLY A PHILLIPS (D.O.) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is KELLY A PHILLIPS (D.O.) associated with Lakewood?
Public fields place KELLY A PHILLIPS (D.O.) around Lakewood, Washington. Always confirm the exact site before visiting.
Does KELLY A PHILLIPS (D.O.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

Similar Providers

SIMEON WESLEY ASHWORTH (DO)

Emergency Medicine Physician
Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States
NPI: 1861462368

DR. BRUCE WAYNE HIGGINBOTHAM (MD)

Family Medicine Physician
101, East 26th Street, Tacoma, Pierce County, Washington, 98421, United States
NPI: 1679544225

IAN DAVID COWAN (MD)

Emergency Medicine Physician
505, South 336th Street, Federal Way, King County, Washington, 98003, United States
NPI: 1326085325

ROBERT JENSEN (MD)

Emergency Medicine Physician
11315 Bridgeport Way SW
NPI: 1164469698

BARBARA SHERRY MEZGER (MD)

Emergency Medicine Physician
11315 Bridgeport Way SW
NPI: 1013955699

EDSON GERRY PONRAJ (MD)

Emergency Medicine Physician
505, South 336th Street, Federal Way, King County, Washington, 98003, United States
NPI: 1396783940

DR. BRIAN REAGAN (M.D.)

Emergency Medicine Physician
7140, Interlaaken Drive Southwest, Holly Hedge, Clinton Park, Lakewood, Pierce County, Washington, 98499, United States
NPI: 1245270651