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

Samuel Kelly

Individual provider Anesthesiologist Assistant · NPI 1013542372

Samuel Kelly is an Anesthesiology Assistant in Waco, Texas. Qualified in 2020, 6 years ago. Practices with Cleveland Clinic, a 6,935-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

100 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone: (254) 202-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 32697602 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1013542372
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 6, 2020
Last updated in NPPESJanuary 27, 2022
Certification dateJanuary 27, 2022
Mailing addressPo Box 844658, Dallas, TX 75284-4658

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Cleveland Clinic — 6935 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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