Kerry Anne Scully Proctor, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in The Dalles, Oregon. She went to University Of Vermont College Of Medicine and graduated in 2001 and has 24 years of diverse experience with area of expertise as Pathology. She is a member of the group practice Mid-columbia Medical Center and her current practice location is
1700 E 19th St, The Dalles, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 296-1111.
Kerry Anne Scully Proctor is licensed to practice in Oregon (license number MD27633) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1235353863.
Physician's Profile
| Full Name | Kerry Anne Scully Proctor |
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| Gender | Female |
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| Speciality | Pathology |
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| Experience | 24 Years |
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| Location | 1700 E 19th St, The Dalles, Oregon |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kerry Anne Scully Proctor attended and graduated from University Of Vermont College Of Medicine in 2001
NPI Data:
- NPI Number: 1235353863
- Provider Enumeration Date: 04/13/2007
- Last Update Date: 12/14/2007
Medicare PECOS Information:
- PECOS PAC ID: 2769570704
- Enrollment ID: I20071108000588
Medical Identifiers
Medical identifiers for Kerry Anne Scully Proctor such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1235353863 | NPI | - | NPPES |
| 8494999 | Medicaid | OR | |
| R0000ZBBWZ | Other | OR | MEDICARE GROUP NO |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 36695 (Iowa) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 5223915-1205 (Utah) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD27633 (Oregon) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Mid-columbia Medical Center | 3779487251 | 97 |
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. Kerry Anne Scully Proctor allows following entities to bill medicare on her behalf.
| Entity Name | Mid-columbia Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053409599 PECOS PAC ID: 3779487251 Enrollment ID: O20031209000244 |
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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. Kerry Anne Scully Proctor 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 |
Kerry Anne Scully Proctor, MD 1700 E 19th St, The Dalles, OR 97058-3317 Ph: (541) 296-1111 | Kerry Anne Scully Proctor, MD 1700 E 19th St, The Dalles, OR 97058-3317 Ph: (541) 296-1111 |
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