Kiley Katherine Fagan, MD in Roanoke, VA

Kiley Katherine Fagan, MD is a medicare enrolled "Dermatology - Dermatopathology" physician in Roanoke, Virginia. Her current practice location is 1 Riverside Cir Ste 300, Roanoke, Virginia. You can reach out to her office (for appointments etc.) via phone at (540) 224-5170.

Kiley Katherine Fagan is licensed to practice in Virginia (license number 0101281436) 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 1003479254.

Contact Information

	Kiley Katherine Fagan, MD
	1 Riverside Cir Ste 300, Roanoke, VA 24016-4962
	(540) 224-5170
	Not Available

Map and Direction

Physician's Profile

Full Name	Kiley Katherine Fagan
Gender	Female
Speciality	Dermatology - Dermatopathology
Location	1 Riverside Cir Ste 300, Roanoke, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003479254
Provider Enumeration Date: 04/15/2019
Last Update Date: 10/09/2024

Medicare PECOS Information:

PECOS PAC ID: 4587998257
Enrollment ID: I20230921004200

Medical Identifiers

Medical identifiers for Kiley Katherine Fagan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003479254	NPI	-	NPPES
10808	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	0101281436 (Virginia)	Secondary
207ND0900X	Dermatology - Dermatopathology	0101281436 (Virginia)	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. Kiley Katherine Fagan allows following entities to bill medicare on her behalf.

Entity Name	Dermatology Associates Of Georgia, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063560803 PECOS PAC ID: 3678547569 Enrollment ID: O20040825001091

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. Kiley Katherine Fagan 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
Kiley Katherine Fagan, MD 213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713 Ph: () -	Kiley Katherine Fagan, MD 1 Riverside Cir Ste 300, Roanoke, VA 24016-4962 Ph: (540) 224-5170

Reviews and Comments

Dermatology Doctors in Roanoke, VA

Dr. Larry Patton, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 4910 Valley View Blvd Nw, Roanoke, VA 24012 Phone: 540-265-1604 Fax: 540-265-1684
Dr. Howard B Pride, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1 Riverside Cir Ste 300, Roanoke, VA 24016 Phone: 540-581-0254
Dr. Clay Mitchell Pickard, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1 Riverside Cir Ste 300, Roanoke, VA 24016 Phone: 540-581-0254 Fax: 540-581-0120
Jarret Faust, PA-C Dermatology Medicare: Medicare Enrolled Practice Location: 1 Riverside Cir Ste 300, Roanoke, VA 24016 Phone: 540-581-0170 Fax: 479-966-4979
Karla Guerra, DO Dermatology Medicare: Medicare Enrolled Practice Location: 1 Riverside Cir, Roanoke, VA 24016 Phone: 540-581-0254 Fax: 540-581-0120
Melanie Rebecca Walter, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 2000 Stephenson Ave., Roanoke, VA 24014 Phone: 540-395-3376 Fax: 540-427-7858

Kiley Katherine Fagan, MD - Medicare Dermatology in Roanoke, VA