DR. JOHN T KELLEY MD
NPI 1871567131
Internal Medicine in Iowa City, IA

Medicare Participation & PECOS Enrollment Status

John Kelley is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

John Kelley is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 7517948631

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20100220000304

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): No

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  16 DME suppliers used 73 Medicare Claims 132 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  9 DME suppliers used 25 Medicare Claims 27 Services Paid

• DME-Other DME (DE001N)

  Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

  2 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Other DME (DE001N)

  Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

  2 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Other DME (DE001N)

  Headgear used with positive airway pressure device (HCPCS:A7035)

  5 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  5 DME suppliers used 14 Medicare Claims 72 Services Paid

• DME-Other DME (DE001N)

  Continuous positive airway pressure (cpap) device (HCPCS:E0601)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

This service was performed 29 times for 29 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

This service was performed 36 times for 36 patients

Anticoagulant management of patient taking warfarin

Anticoagulant management for a patient taking warfarin involves monitoring and adjusting medication to prevent blood clots while minimizing the risk of bleeding. Warfarin is a medication that slows down the process of clot formation in your body. It's often prescribed for conditions like atrial fibrillation or after certain surgeries to prevent dangerous clots. However, too much can cause bleeding, while too little might not prevent clots. Monitoring involves regular blood tests called INR tests, which measure how quickly your blood clots. Based on these results, your healthcare provider will adjust your warfarin dosage to

This service was performed 39 times for 11 patients

Automated urinalysis test

An automated urinalysis test is a medical procedure that checks for various disorders such as urinary tract infections, kidney diseases, and diabetes by analyzing your urine. The test is done using an automated machine, which makes it quicker and more accurate than manual methods. It evaluates several components of your urine like its color, clarity, concentration, and contents including sugar, protein, red and white blood cells, and other substances. The results can provide valuable information about your overall health and help your doctor diagnose any potential issues. It's a simple, non-invasive test that usually requires you to provide a urine sample

This service was performed 46 times for 44 patients

Blood test, clotting time

A clotting time blood test is a diagnostic procedure used to measure how long it takes for your blood to clot. This test is important as it can help your doctor assess your risk of excessive bleeding or developing clots. During the test, a small sample of your blood will be drawn from a vein in your arm. This sample is then sent to a lab where it's mixed with certain substances and the time it takes for a clot to form is measured. The results can help your doctor diagnose conditions like hemophilia or von Willebrand disease, or monitor the effectiveness of blood-thinning medications.

This service was performed 77 times for 13 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine medical visit for patients who have previously been seen by the physician or healthcare provider. During this visit, which typically lasts between 10 to 19 minutes, the provider will discuss your current health status, review any ongoing treatments or medications, and address any new or existing health concerns you may have. This visit may also include a basic physical examination. It's a crucial part of maintaining your overall health, as it allows your provider to monitor your health condition regularly and adjust treatments as necessary. Please remember to bring up any health-related questions or concerns you may have during this visit.

This service was performed 82 times for 74 patients

Established patient office or other outpatient visit, 20-29 minutes

An established patient office or outpatient visit of 20-29 minutes is a medical consultation for patients who have previously been seen by the doctor or are currently undergoing treatment. During this visit, the healthcare provider will review your health history, discuss any new or ongoing symptoms, perform a physical examination if necessary, and manage your treatment plan. This could include prescribing medication, ordering tests, or discussing lifestyle changes. It's a shorter appointment, typically used for follow-up visits or routine check-ups, rather than for new or complex health issues.

This service was performed 279 times for 183 patients

Established patient office or other outpatient visit, 30-39 minutes

An established patient office or outpatient visit for 30-39 minutes is a common type of medical appointment for individuals who have previously seen the healthcare provider. During this visit, the healthcare provider will assess your current health status, review any ongoing treatments or medications, and address any new or existing health concerns you may have. This could include discussing symptoms, performing a physical examination, or planning further tests or treatments. The length of the visit (30-39 minutes) allows ample time for a thorough discussion and examination. It's important to come prepared with any questions or concerns you may have to make the most

This service was performed 279 times for 254 patients

Hemoglobin a1c level

The Hemoglobin A1C test, also known as the HbA1c, is a simple blood test used to measure your average blood sugar levels over the past 2-3 months. It's commonly used to diagnose and monitor diabetes. The test works by measuring the percentage of blood sugar attached to hemoglobin, the protein in your red blood cells that carries oxygen. A higher A1C level means you have more sugar in your blood, which can lead to diabetes or indicate poor control of diabetes if you have already been diagnosed. It's a crucial test because unlike regular blood sugar tests

This service was performed 33 times for 27 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, Preservative Free, is a type of flu shot designed to protect you against the influenza virus. It's called a split virus vaccine because the virus used in the vaccine has been broken down or split into pieces, which cannot cause the flu. This vaccine is also preservative-free, meaning it doesn't contain substances like thimerosal, which are often added to vaccines to prevent contamination by bacteria or fungi. It's prepared in sterile conditions and is given as an injection, usually in your upper arm. This vaccine is updated annually to protect

This service was performed 25 times for 25 patients

Insertion of needle into vein for collection of blood sample

The procedure you're referring to is known as venipuncture. It's a common, minimally invasive procedure where a medical professional inserts a small, thin needle into one of your veins, typically in your arm or hand. This allows them to collect a sample of your blood for testing. The test results can help diagnose a variety of health conditions, monitor ongoing health problems, or check the effectiveness of a treatment you're receiving. You might feel a slight pinch or sting when the needle goes in, but it's usually over quickly. After the sample is collected, the needle is removed and a small

This service was performed 215 times for 182 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.55 for a new patient copayment and $23.51 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 52245 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. John Kelley is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1871567131 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 15 providers are registered at the same or nearby location.

Frequently Asked Questions