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Active NPI 1760425201 Individual Practitioner Male Practitioner

Michael C Kelly , NP

Nurse Practitioner • Olympia, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Michael Kelly, NP is a certified Nurse Practitioner practicing in Olympia, WA. With approximately 24 years of clinical experience since completing medical education in 2002, Michael Kelly delivers high-quality medical care to the local community at 413 LILLY RD NE.

Michael Kelly maintains professional affiliations with Olympia Emergency Care Physicians Pllc, Western Washington Emergency Physicians Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit with moderate level of medical decision making, emergency department visit for life threatening or functioning severity, routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

413 Lilly Rd Ne

Olympia, WA 985065133

Telephone 3604919480
Associated Practice Facility / Clinic
🏢 Credena Health Llc Facility NPI 1487696787

Medicare Profile & Education

Medical School

Other

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Olympia, WA

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
24 Yrs +13.4 yrs vs City Avg
City Avg: 10.6 Yrs
State Avg: 11.0 Yrs
Regional Practice Density
66 Specialists

Practicing in Olympia, WA (2339 Statewide)

Telehealth Adoption Rate
12.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
91.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kelly (24 Years) 24 Yrs
Olympia Specialty Average (10.6 Years) 10.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99284 Emergency department visit with moderate level of medical decision making
161 160 $1159.47 $99.08
99285 Emergency department visit for life threatening or functioning severity
80 79 $1713.53 $143.92
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
23 21 $90.22 $6.70
99283 Emergency department visit with low level of medical decision making
22 22 $664.45 $58.51

Medical Specialties & State Licenses

CMS Verified: 2021-07-06
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License WA AP30006322

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
9635574 (WA)
Commercial Insurance / Payer ID Wa Crime Victims
8906877
Commercial Insurance / Payer ID Regence Bs
6059KE
Commercial Insurance / Payer ID Wa L & I
199382

Hospital & Practice Group Affiliations

Olympia Emergency Care Physicians Pllc

3900 Capital Mall Dr Sw, Olympia, WA 985028654

Phone: 2534034901

Western Washington Emergency Physicians Pllc

14815 Pacific Ave S, Tacoma, WA 984444654

Phone: 2536978660

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jeffrey Howard , MD

Emergency Medicine

NPI 1003857145

Doctor of Medicine (M.D.)

Raffy Jatamosa

Nurse Practitioner

NPI 1013542885
Amory Ballantine , LICSW

Social Worker - Clinical

NPI 1023748407

Licensed Independent Clinical Social Worker

Eileen Ravella , PA-C

Physician Assistant

NPI 1043237134

Physician Assistant (Certified)

Dr. Bruce Lincoln , MD

Emergency Medicine

NPI 1053357889

Doctor of Medicine (M.D.)

Wendy Kruse , ARNP

Nurse Practitioner - Family

NPI 1063188795

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 06, 2021

Nurse Practitioner (License #AP30006322 in WA)

NPI Profile Active November 27, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location November 27, 2007

Registered at 413 LILLY RD NE, OLYMPIA, WA 985065133 (Tel: 3604919480)

📍
Updated Business Mailing Address November 27, 2007

Registered at PO BOX 5007, LACEY, WA 985095007 (Tel: 8005990166)

👤
Provider Name / Credentials Updated November 27, 2007

Recorded as MICHAEL KELLY, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 27, 2007

Nurse Practitioner (License #RN00124941 in WA)

🟢
Initial NPI Registration & Enumeration June 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760425201
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 13, 2006
Last Update: July 06, 2021
Sole Proprietor: No

Mailing Address

Po Box 5007

Lacey, WA 985095007

Phone: 8005990166

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.