Kelly Richardson, MD05/ in Wyoming, MI - Medicare Internal Medicine

Kelly Richardson, MD05/ is a medicare enrolled "Internal Medicine - Adolescent Medicine" physician in Wyoming, Michigan. Her current practice location is 1200 56th St Sw, Wyoming, Michigan. You can reach out to her office (for appointments etc.) via phone at (616) 243-5707.

Kelly Richardson is licensed to practice in Michigan (license number 4301079769) 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 1548278971.

Contact Information

	Kelly Richardson, MD05/
	1200 56th St Sw, Wyoming, MI 49509-9704
	(616) 243-5707
	(616) 243-1170

Map and Direction

Physician's Profile

Full Name	Kelly Richardson
Gender	Female
Speciality	Internal Medicine - Adolescent Medicine
Location	1200 56th St Sw, Wyoming, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548278971
Provider Enumeration Date: 08/03/2006
Last Update Date: 10/18/2011

Medicare PECOS Information:

PECOS PAC ID: 4789683053
Enrollment ID: I20061214000167

Medical Identifiers

Medical identifiers for Kelly Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548278971	NPI	-	NPPES
381360529	Other	MI	TAX ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	4301079769 (Michigan)	Secondary
207RA0000X	Internal Medicine - Adolescent Medicine	4301079769 (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 Richardson allows following entities to bill medicare on her behalf.

Entity Name	Brookville Pediatric & Internal Medicine, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346200847 PECOS PAC ID: 0446273510 Enrollment ID: O20060104000851

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 Richardson 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 Richardson, MD05/ 1200 56th St Sw, Wyoming, MI 49509-9704 Ph: (616) 243-5707	Kelly Richardson, MD05/ 1200 56th St Sw, Wyoming, MI 49509-9704 Ph: (616) 243-5707

Reviews and Comments

Internal Medicine Doctors in Wyoming, MI

Mark J Tieszen, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-252-7200
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Dr. John Allen Key, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-241-2333 Fax: 616-452-6767
Danielle Light, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-252-7200

Kelly Richardson, MD05/ - Medicare Internal Medicine in Wyoming, MI