Dr Kellyrose Mary Nichols, DO is a medicare enrolled "Family Medicine" physician in Le Roy, New York. She went to Philadelphia College Of Osteopathic Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice University Of Rochester and her current practice location is
8745 Lake Street Rd, Le Roy, New York. You can reach out to her office (for appointments etc.) via phone at
(585) 768-2620.
Dr Kellyrose Mary Nichols is licensed to practice in New York (license number 279405) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013274638.
Physician's Profile
Full Name | Dr Kellyrose Mary Nichols |
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Gender | Female |
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Speciality | Family Practice |
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Experience | 12 Years |
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Location | 8745 Lake Street Rd, Le Roy, New York |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Kellyrose Mary Nichols attended and graduated from Philadelphia College Of Osteopathic Medicine in 2012
NPI Data:
- NPI Number: 1013274638
- Provider Enumeration Date: 04/20/2012
- Last Update Date: 06/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 1355658519
- Enrollment ID: I20150921001340
Medical Identifiers
Medical identifiers for Dr Kellyrose Mary Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013274638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 279405 (New York) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
University Of Rochester | 5799699088 | 814 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kellyrose Mary Nichols allows following entities to bill medicare on her behalf.
Entity Name | University Of Rochester |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1710226824 PECOS PAC ID: 5799699088 Enrollment ID: O20130619000286 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kellyrose Mary Nichols is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Kellyrose Mary Nichols, DO 8745 Lake Street Rd, Le Roy, NY 14482-9344 Ph: (585) 768-2620 | Dr Kellyrose Mary Nichols, DO 8745 Lake Street Rd, Le Roy, NY 14482-9344 Ph: (585) 768-2620 |
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