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

Tatiana Simone Kelley, MD

Individual provider Family Medicine Physician · NPI 1902480445

Tatiana Simone Kelley, MD is a Family Practice in Elk Grove, California. Graduated from Southern Illinois University School of Medicine in 2020, 6 years ago. Practices with Dignity Health Medical Foundation, a 1,204-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
6
Trained at
Southern Illinois University School of Medicine
Licensed in
CA
In the registry since
2021
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

9394 Big Horn Blvd
Elk Grove, CA 95758-7977
Phone: (916) 691-8500
Fax: (916) 691-8589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A191453 (CA)

Record details

NPI number1902480445
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 11, 2021
Last updated in NPPESDecember 3, 2024
Certification dateDecember 3, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Dignity Health Medical Foundation — 1204 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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