Derk Kelly, PT,DPT in Wauwatosa, WI - Medicare Physical Therapist Provider

Derk Kelly, PT,DPT is a medicare enrolled "Physical Therapist" provider in Wauwatosa, Wisconsin. His current practice location is 6004 W Wells St, Wauwatosa, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (804) 349-5941.

Derk Kelly is licensed to practice in Wisconsin (license number 12071-24) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114272093.

Contact Information

	Derk Kelly, PT,DPT
	6004 W Wells St, Wauwatosa, WI 53213-3244
	(804) 349-5941
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Derk Kelly
Gender	Male
Speciality	Physical Therapist
Location	6004 W Wells St, Wauwatosa, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114272093
Provider Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012

Medicare PECOS Information:

PECOS PAC ID: 8527461219
Enrollment ID: I20210719001368

Medical Identifiers

Medical identifiers for Derk Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114272093	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	12071-24 (Wisconsin)	Primary

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. Derk Kelly allows following entities to bill medicare on his behalf.

Provider Name	Benchmark Physical Therapy Of Oregon Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1801257191 PECOS PAC ID: 0143510602 Enrollment ID: O20160613001008

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. Derk Kelly 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
Derk Kelly, PT,DPT 6004 W Wells St, Wauwatosa, WI 53213-3244 Ph: (804) 349-5941	Derk Kelly, PT,DPT 6004 W Wells St, Wauwatosa, WI 53213-3244 Ph: (804) 349-5941

Reviews and Comments

Physical Therapist in Wauwatosa, WI

Michelle Keating, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7500 W North Ave, Wauwatosa, WI 53213 Phone: 414-258-6170
Ms. Kathy Louise Shebesta, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2626 N 76th St, Suite 105, Wauwatosa, WI 53213 Phone: 414-774-7794 Fax: 414-607-3971
Ms. Lauren Croal, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 11904 W North Ave, Suite 100, Wauwatosa, WI 53226 Phone: 414-453-8616 Fax: 414-453-6150
Dr. Eric King, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 10930 W Potter Rd Ste C, Wauwatosa, WI 53226 Phone: 414-400-6556 Fax: 414-400-6557
Stacey Sipiorski, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2999 N Mayfair Rd, Suite 300, Wauwatosa, WI 53222 Phone: 414-479-3737 Fax: 414-479-3733
Ms. Alyson Stearns, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2999 N Mayfair Rd Ste 300, Wauwatosa, WI 53222 Phone: 414-479-3737
Linda Snyder, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2999 N Mayfair Rd, Wauwatosa, WI 53222 Phone: 414-479-1945

Derk Kelly, PT,DPT - Medicare Physical Therapist in Wauwatosa, WI