Kimberly Diane Davis, DO in East Granby, CT

Kimberly Diane Davis, DO is a medicare enrolled "Family Medicine" physician in East Granby, Connecticut. Her current practice location is 13 Church Rd, East Granby, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 653-4526.

Kimberly Diane Davis is licensed to practice in Connecticut (license number 75672) 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 1639791379.

Contact Information

	Kimberly Diane Davis, DO
	13 Church Rd, East Granby, CT 06026-9406
	(860) 653-4526
	(833) 471-6186

Map and Direction

Physician's Profile

Full Name	Kimberly Diane Davis
Gender	Female
Speciality	Family Medicine
Location	13 Church Rd, East Granby, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639791379
Provider Enumeration Date: 05/15/2020
Last Update Date: 01/23/2025

Medicare PECOS Information:

PECOS PAC ID: 0042656142
Enrollment ID: I20240312001142

Medical Identifiers

Medical identifiers for Kimberly Diane Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639791379	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	75672 (Connecticut)	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. Kimberly Diane Davis allows following entities to bill medicare on her behalf.

Entity Name	East Granby Family Practice Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154308229 PECOS PAC ID: 6709873144 Enrollment ID: O20040428000607

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. Kimberly Diane Davis 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
Kimberly Diane Davis, DO 71 Haynes St, Manchester, CT 06040-4131 Ph: (860) 533-4679	Kimberly Diane Davis, DO 13 Church Rd, East Granby, CT 06026-9406 Ph: (860) 653-4526

Reviews and Comments

Family Medicine Doctors in East Granby, CT

Steven R Dieterich, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 13 Church Rd, East Granby, CT 06026 Phone: 860-653-4526 Fax: 860-653-5209
Ms. Elizabeth S Freedman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 13 Church Rd, East Granby, CT 06026 Phone: 860-653-4526 Fax: 860-653-5307
Mrs. Anne M Reiher, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 13 Church Rd, East Granby, CT 06026 Phone: 860-653-5624 Fax: 860-653-5209
Khuram R Ghumman, MD, MPH, CPE, FAAFP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 13 Church St, East Granby, CT 06026 Phone: 860-653-4526 Fax: 860-653-5209
Mr. Edward M Ewald, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 13 Church Rd, East Granby, CT 06026 Phone: 860-653-4526 Fax: 860-653-5209
Tejal Kothari Shaikh, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 13 Church Rd, East Granby, CT 06026 Phone: 860-653-4526

Kimberly Diane Davis, DO - Medicare Family Medicine in East Granby, CT