Mickenzie Dougherty, MS, RD, LDN in Media, PA - Medicare Dietitian, Registered Provider

Mickenzie Dougherty, MS, RD, LDN is a medicare enrolled "Dietitian, Registered" provider in Media, Pennsylvania. Her current practice location is 49 Kirk Ln, Media, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (800) 736-3739.

Mickenzie Dougherty is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558012971.

Contact Information

	Mickenzie Dougherty, MS, RD, LDN
	49 Kirk Ln, Media, PA 19063-2137
	(800) 736-3739
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mickenzie Dougherty
Gender	Female
Speciality	Dietitian, Registered
Location	49 Kirk Ln, Media, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558012971
Provider Enumeration Date: 01/18/2022
Last Update Date: 08/01/2025

Medicare PECOS Information:

PECOS PAC ID: 6204292477
Enrollment ID: I20230512000918

Medical Identifiers

Medical identifiers for Mickenzie Dougherty such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558012971	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	(* (Not Available))	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. Mickenzie Dougherty allows following entities to bill medicare on her behalf.

Provider Name	Andersons Nutrition
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1396221347 PECOS PAC ID: 7810252699 Enrollment ID: O20180525001877

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. Mickenzie Dougherty 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
Mickenzie Dougherty, MS, RD, LDN 49 Kirk Ln, Media, PA 19063-2137 Ph: () -	Mickenzie Dougherty, MS, RD, LDN 49 Kirk Ln, Media, PA 19063-2137 Ph: (800) 736-3739

Reviews and Comments

Dietitian, Registered in Media, PA

Marie Vadella, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 24 Veterans Sq, Media, PA 19063 Phone: 814-880-4039
Dr. Jean Elena Tomezsko, PHD, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4 Prince Eugene Ln, Media, PA 19063 Phone: 610-565-2989
Rebecca Killion, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 24 Veterans Sq, Media, PA 19063 Phone: 215-431-8980
Jessica Spiro, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 866 Whistle Ln, Media, PA 19063 Phone: 310-909-6057
Lynn W Nichols, RD LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1068 W Baltimore Pike, Media, PA 19063 Phone: 610-891-3490 Fax: 610-891-3493
Mrs. Lori Perikles Enriquez, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 212 Wrights Ln, Media, PA 19063 Phone: 610-476-8877
Samantha Bluj, RD, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 24 Veterans Sq, Media, PA 19063 Phone: 610-783-3600 Fax: 610-514-9849

Mickenzie Dougherty, MS, RD, LDN - Medicare Dietitian in Media, PA