Daniel H Kelly, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Jackson, Mississippi. His current practice location is
2500 N State St, Jackson, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 984-5607.
Daniel H Kelly is licensed to practice in * (Not Available) (license number ) 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 1417480831.
Physician's Profile
Full Name | Daniel H Kelly |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2500 N State St, Jackson, Mississippi |
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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: 1417480831
- Provider Enumeration Date: 04/04/2017
- Last Update Date: 02/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 2163788647
- Enrollment ID: I20230618000025
Medical Identifiers
Medical identifiers for Daniel H Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417480831 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RC0000X | Internal Medicine - Cardiovascular Disease | 27519 (Mississippi) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (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. Daniel H Kelly allows following entities to bill medicare on his behalf.
Entity Name | Medical Foundation Of Central Mississippi Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1992774814 PECOS PAC ID: 1153216411 Enrollment ID: O20040217000380 |
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Entity Name | Mississippi Baptist Medical Center, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1467589556 PECOS PAC ID: 9234026600 Enrollment ID: O20110707000181 |
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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. Daniel H 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 |
Daniel H Kelly, MD 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5607 | Daniel H Kelly, MD 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5607 |
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