● Active Type 1 · Individual

Samuel Kelly

Anesthesiologist Assistant·Waco, TX· NPI 1013542372 · Enumerated 2020 · 6 years on NPI

Kelly is 1 of 21 anesthesiologist assistant providers in Waco and 1 of 500 in Texas.

NPI age

6 years

Enumerated 2020-03-06

Primary specialty

Anesthesiologist Assistant

Plus 1 subspecialty

Licensed in

1 state

Status

Active

No deactivations on record

Last NPPES update

2022-01-27

Source: monthly bulk 2026-05

Sole proprietor

May be part of a larger org

How this provider compares

Across 500 active anesthesiologist assistant providers in Texas.

NPI age

6 years

≈ at median (6 yr)

State licenses

1 state

13% of peers hold multiple states

Subspecialties

In the 32% of peers with subspecialties

NPI lifetime · 2020 → 2026

2020-03Enumerated in NPPES

2020 2026

Where they practice

Practice location

100 Hillcrest Medical Blvd

Waco, TX 767128897

📞 2542022000

Mailing address

Po Box 844658

Dallas, TX 752844658

📞 2547242111

Specialties

Physician Assistants & Advanced Practice Nursing Providers › Anesthesiologist Assistant

Anesthesiologist Assistant Primary

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a...

TX license #32697602 taxonomy 367H00000X
Student in an Organized Health Care Education/Training Program

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

taxonomy 390200000X

Practice context

Part of a multi-provider practice. 202 other active providers share this practice address in NPPES.

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How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.