Sean Kelley, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Jackson, California. He graduated from medical school in 2014 and has 12 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Michael P Sherman Md Phd A Medical Corporation 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 | 12 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. |
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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 |
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| 1194144170 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0202X | Radiology - Diagnostic Radiology | A141999 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Michael P Sherman Md Phd A Medical Corporation | 9537113212 | 14 |
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 |
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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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