Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Russell Phelps Kelley IV, MD

Individual provider Diagnostic Radiology Physician · NPI 1215375373

Dr. Russell Phelps Kelley IV, MD is a Diagnostic Radiology in Dallas, Texas. Graduated from Harvard Medical School in 2013, 13 years ago. Practices with Pacific Radiology Group Inc, a 30-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California, Massachusetts, North Carolina and Texas.

Years since qualifying
13
Trained at
Harvard Medical School
Licensed in
CA, MA, NC, TX
In the registry since
2013
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone: (510) 689-9500
Fax: (877) 880-2039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 75 Francis St, Boston, MA 02115-6110 — (617) 732-5500

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 1018091 (MA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence S3004 (TX)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence A135999 (CA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 2024-03651 (NC)

Record details

NPI number1215375373
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 11, 2013
Last updated in NPPESDecember 20, 2024
Certification dateDecember 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 2013 (13 years in practice)
Group practice Pacific Radiology Group Inc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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