Colleen Anne Keane-mullooly, RNC,MS,WHNP is a medicare enrolled "Nurse Practitioner" physician in Milwaukee, Wisconsin. Her current practice location is
302 N Jackson St, Milwaukee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 347-2297.
Colleen Anne Keane-mullooly is licensed to practice in Wisconsin (license number 2232-33) 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 1043255367.
Physician's Profile
| Full Name | Colleen Anne Keane-mullooly |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 302 N Jackson St, Milwaukee, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043255367
- Provider Enumeration Date: 06/19/2006
- Last Update Date: 12/30/2013
Medicare PECOS Information:
- PECOS PAC ID: 2163829516
- Enrollment ID: I20210928000439
Medical Identifiers
Medical identifiers for Colleen Anne Keane-mullooly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1043255367 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207VG0400X | Obstetrics & Gynecology - Gynecology | 2232-033 (Wisconsin) | Secondary |
| 363L00000X | Nurse Practitioner | 2232-33 (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. Colleen Anne Keane-mullooly allows following entities to bill medicare on her behalf.
| Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
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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. Colleen Anne Keane-mullooly 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 |
Colleen Anne Keane-mullooly, RNC,MS,WHNP 302 N Jackson St, Milwaukee, WI 53202-5904 Ph: (608) 347-2297 | Colleen Anne Keane-mullooly, RNC,MS,WHNP 302 N Jackson St, Milwaukee, WI 53202-5904 Ph: (608) 347-2297 |
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