Kelly Ann O'sullivan, MD in Vancouver, WA

Kelly Ann O'sullivan, MD is a medicare enrolled "Family Medicine - Geriatric Medicine" physician in Vancouver, Washington. Her current practice location is 750 Se Fairwinds Loop, Vancouver, Washington. You can reach out to her office (for appointments etc.) via phone at (231) 838-2765.

Kelly Ann O'sullivan is licensed to practice in Michigan (license number 4301081068) 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 1750332474.

Contact Information

	Kelly Ann O'sullivan, MD
	750 Se Fairwinds Loop, Vancouver, WA 98661-8087
	(231) 838-2765
	Not Available

Map and Direction

Physician's Profile

Full Name	Kelly Ann O'sullivan
Gender	Female
Speciality	Family Medicine - Geriatric Medicine
Location	750 Se Fairwinds Loop, Vancouver, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750332474
Provider Enumeration Date: 05/15/2006
Last Update Date: 03/17/2018

Medicare PECOS Information:

PECOS PAC ID: 1052392305
Enrollment ID: I20040525000344

Medical Identifiers

Medical identifiers for Kelly Ann O'sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750332474	NPI	-	NPPES
N19510003	Other	MI	MEDICARE INDIV PTAN
5185089	Medicaid	MI
ON19510	Other	MI	MEDICARE GROUP PTAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	MD60593078 (Washington)	Secondary
207QG0300X	Family Medicine - Geriatric Medicine	4301081068 (Michigan)	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. Kelly Ann O'sullivan allows following entities to bill medicare on her behalf.

Entity Name	Advantage Health/saint Mary's Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376862151 PECOS PAC ID: 4082807961 Enrollment ID: O20101023000279

Entity Name	Noch Physician Billing Company Llc
Entity Type	Part B Supplier - Hospital Department(s)
Entity Identifiers	NPI Number: 1972550580 PECOS PAC ID: 8527078583 Enrollment ID: O20140401000168

Entity Name	Saint Marys Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063917425 PECOS PAC ID: 4981500436 Enrollment ID: O20180511000758

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. Kelly Ann O'sullivan 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
Kelly Ann O'sullivan, MD 750 Se Fairwinds Loop, Vancouver, WA 98661-8087 Ph: (231) 838-2765	Kelly Ann O'sullivan, MD 750 Se Fairwinds Loop, Vancouver, WA 98661-8087 Ph: (231) 838-2765

Reviews and Comments

Family Medicine Doctors in Vancouver, WA

Andrea Vallejo Carnie, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7410 Delaware Ln Uppr Level, Vancouver, WA 98664 Phone: 360-566-4402
David Malekooti, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 2101 Ne 139th St Ste 450, Vancouver, WA 98686 Phone: 360-487-4848
Mrs. Sherilyn Marie Foltz Cook, DO Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 16500 Se 15th St, Ste 100, Vancouver, WA 98683 Phone: 360-254-4402 Fax: 360-892-9241
Dr. Matthew Howard Rose, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 650 N Devine Rd, Vancouver, WA 98661 Phone: 360-952-4457 Fax: 360-828-7409
Dr. Michele Lynn Sequeira, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 12607 Se Mill Plain Blvd, Vancouver, WA 98684 Phone: 360-891-6208 Fax: 360-418-6006
Dr. Kevin Deweber, MD, FAMSSM, FAAFP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 E. 33rd Street, Family Medicine Of Sw Washington, Vancouver, WA 98663 Phone: 360-514-7550 Fax: 360-514-7494
Dr. David Paik, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 E 33rd St, Suite 100, Vancouver, WA 98663 Phone: 360-514-7550 Fax: 360-514-7553

Kelly Ann O'sullivan, MD - Medicare Family Medicine in Vancouver, WA