DR. TERESA GROSS KELLY (M.D) – Diagnostic Radiology Physician, NPI 1275580672
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,101 DIAGNOSTIC RADIOLOGY in WI
Provider Addresses for DR. TERESA GROSS KELLY (M.D)
9000 W Wisconsin Ave
PEDIATRIC RADIOLOGY
Milwaukee, WI 532264874
Phone: (414) 266-1686
Type: Location
9200 W Wisconsin Ave
Milwaukee, WI 532263522
Phone: (414) 805-2060
Fax: (414) 259-9290
Type: Location
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 495259746
Phone: (616) 363-7272
Fax: (616) 361-5828
Type: Mailing
9000, West Wisconsin Avenue, Cannon Park, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States
PEDIATRIC RADIOLOGY
MILWAUKEE, WI 532264874
Phone: (414) 266-1686
Type: Mailing
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: 2024-11-13
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 |
|---|---|---|---|---|
| I20090625000439 | I | Diagnostic Radiology | WI | TBD |
| I20241113004286 | I | Diagnostic Radiology | MI | 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 53226)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Physician Assistant | MI |
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