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

Mr. Kyle Kelly, PA

Individual provider Physician Assistant · NPI 1457948804

Mr. Kyle Kelly, PA is a Physician Assistant in Westlake, Ohio. Qualified in 2022, 4 years ago. Practices with Apex Dermatology and Skin Surgery Center, LLC, a 52-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4350 Crocker Rd Ste 300
Westlake, OH 44145-6329
Phone: (440) 558-8005
Fax: (440) 835-4790
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.00763RX (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1457948804
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 30, 2020
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Apex Dermatology And Skin Surgery Center, Llc — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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