Samuel Robert Kelly
NPI 1174018022ActiveIndividual· Dentist, General Practice· Salem, OR
Dentist, General Practice in Salem, Oregon, licensed in OR, with an NPI issued in June 2018. Part D covered 33 prescriptions written in 2024, 97% of them generic. Patterson Companies, Inc. reported $20.60 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1174018022 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jun 23, 2018 |
| Last updated in NPPES | Jun 23, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | D10822 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 33 · 33 30-day fills |
|---|---|
| Patients | 27 |
| Total drug cost | $224.78 |
| Generic share | 97% of claims |
Industry payments (Open Payments)
- 2024$20.60 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Patterson Companies, Inc. | $20.60 | 1 |
What the 2024 payments were for
- Food and Beverage$20.60 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 174 general dentists in Salem · All general dentists in Oregon