Kelli Block, is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Dacula, Georgia. Her current practice location is
2300 Liam Ave Ste 104, Dacula, Georgia. You can reach out to her office (for appointments etc.) via phone at
(470) 294-0052.
Kelli Block is licensed to practice in Georgia (license number PT016161) 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 1841918372.
Physician's Profile
Full Name | Kelli Block |
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Gender | Female |
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Speciality | Physical Medicine & Rehabilitation |
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Location | 2300 Liam Ave Ste 104, Dacula, Georgia |
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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: 1841918372
- Provider Enumeration Date: 08/19/2022
- Last Update Date: 08/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 0648656371
- Enrollment ID: I20221004002965
Medical Identifiers
Medical identifiers for Kelli Block such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1841918372 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208100000X | Physical Medicine & Rehabilitation | PT016161 (Georgia) | 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. Kelli Block allows following entities to bill medicare on her behalf.
Entity Name | Back In The Game Physical Therapy, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1962669275 PECOS PAC ID: 9133380082 Enrollment ID: O20120419000722 |
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Entity Name | Fyz 400 Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1912622960 PECOS PAC ID: 0547638736 Enrollment ID: O20221118001663 |
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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. Kelli Block 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 |
Kelli Block, 236 Candler Way, Williamson, GA 30292-3284 Ph: (678) 577-3020 | Kelli Block, 2300 Liam Ave Ste 104, Dacula, GA 30019-2265 Ph: (470) 294-0052 |
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