Dr Timothy Michael Kelley Jr, DC is a medicare enrolled "Chiropractor" provider in Heuvelton, New York. His current practice location is
94 State St, Heuvelton, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 344-7296.
Dr Timothy Michael Kelley Jr is licensed to practice in New York (license number X011547-1) 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 1356443972.
Healthcare Provider's Profile
| Full Name | Dr Timothy Michael Kelley Jr |
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| Gender | Male |
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| Speciality | Chiropractor |
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| Location | 94 State St, Heuvelton, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1356443972
- Provider Enumeration Date: 09/03/2006
- Last Update Date: 09/18/2009
Medicare PECOS Information:
- PECOS PAC ID: 8123037702
- Enrollment ID: I20080918000492
Medical Identifiers
Medical identifiers for Dr Timothy Michael Kelley Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1356443972 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 3060 (Massachusetts) | Secondary |
| 111N00000X | Chiropractor | X011547-1 (New York) | 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. Dr Timothy Michael Kelley Jr allows following entities to bill medicare on his behalf.
| Provider Name | Timothy M Kelley Dc Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1104093749
PECOS PAC ID: 1951478882
Enrollment ID: O20080918000498 |
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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 Timothy Michael Kelley Jr 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 |
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Dr Timothy Michael Kelley Jr, DC
94 State St,
Heuvelton, NY 13654
Ph: (315) 344-7296 | Dr Timothy Michael Kelley Jr, DC
94 State St,
Heuvelton, NY 13654
Ph: (315) 344-7296 |
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