Sean Kelley, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Jackson, California. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Mother Lode Diagnostic Imaging Inc, Mother Lode Diagnostic Imaging Inc and his current practice location is
200 Mission Blvd, Jackson, California. You can reach out to his office (for appointments etc.) via phone at
(209) 223-7500.
Sean Kelley is licensed to practice in California (license number A141999) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1194144170.
Physician's Profile
Full Name | Sean Kelley |
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Gender | Male |
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Speciality | Diagnostic Radiology |
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Experience | 10 Years |
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Location | 200 Mission Blvd, Jackson, California |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Sean Kelley graduated from medical school in 2014
NPI Data:
- NPI Number: 1194144170
- Provider Enumeration Date: 04/07/2014
- Last Update Date: 05/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 6406180108
- Enrollment ID: I20190701000768
Medical Identifiers
Medical identifiers for Sean Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194144170 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0202X | Radiology - Diagnostic Radiology | A141999 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Mother Lode Diagnostic Imaging Inc | 9739176892 | 3 |
Mother Lode Diagnostic Imaging Inc | 9739176892 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sean Kelley allows following entities to bill medicare on his behalf.
Entity Name | University Of California Sfgh Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1063487122 PECOS PAC ID: 5496668410 Enrollment ID: O20031106000503 |
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Entity Name | Mother Lode Diagnostic Imaging Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1053456061 PECOS PAC ID: 9739176892 Enrollment ID: O20040623001281 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sean Kelley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Sean Kelley, MD 406 S Lexington Dr, Folsom, CA 95630-6879 Ph: () - | Sean Kelley, MD 200 Mission Blvd, Jackson, CA 95642-2564 Ph: (209) 223-7500 |
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