Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael Timothy Kelley, MSPA-C

Individual provider Surgical Physician Assistant · NPI 1073571816

Michael Timothy Kelley, MSPA-C is a Physician Assistant in Tempe, Arizona. Qualified in 1995, 31 years ago. Practices with Smi Imaging LLC, a 376-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
31
Licensed in
AZ
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

6625 S Rural Rd Ste 104
Tempe, AZ 85283-3717
Phone: (480) 833-4515
Fax: (480) 833-5078
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5505 W Chandler Blvd Ste 11, Chandler, AZ 85226-3683 — (480) 659-2571

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence AZ3829 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1073571816
Entity typeIndividual (Type 1)
GenderMale
Credentials MSPA-C
Sole proprietorNo
NPI enumeratedMay 2, 2006
Last updated in NPPESAugust 8, 2023
Certification dateAugust 8, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Smi Imaging Llc — 376 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations39 on file with Medicare

Other providers in Tempe