CMS-1500 Box 24J / 33a • NPI
1912475393
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
20 S PARK ST RM M417, MADISON, WI, 53715-1348
✓ 9-Digit EDI 837 ZIP+4 (53715-1348)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1912475393 (KATLYNN ANN KELLEY, NP-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1912475393)
Medicare Beneficiaries
53
Total Billed Services
464
Distinct CPT/HCPCS Codes
4
Medicare Allowed Total
$27,488.55
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 114 |
99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 26 |
99316 | Nursing facility discharge management, more than 30 minutes | 16 |
G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 216 |
G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 72 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 15 | 12 |
| Allopurinol Allopurinol | 33 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 51 | <11 |
| Atenolol Atenolol | 11 | <11 |
| Atorvastatin Calcium Atorvastatin Calcium | 45 | 13 |
| Baclofen Baclofen | 17 | <11 |
| Benazepril Hcl Benazepril Hcl | 14 | <11 |
| Breyna Budesonide/Formoterol Fumarate | 13 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1912475393 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KATLYNN ANN KELLEY, NP-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 20 S PARK ST RM M417, MADISON, WI, 53715-1348 |
| Practice Telephone / Fax | Tel: (414) 573-8992 |
| Administrative Mailing Address | 335 LONGFIELD ST, EVANSVILLE, WI, 53536-1236 |
| Enumeration & Last Sync | Enumerated: 2018-11-05 | CMS Record Updated: 2018-11-05 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KATLYNN ANN KELLEY, NP-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: WI | License: 8794-33 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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