Holly Keddington, PA-C is a medicare enrolled "Physician Assistant" in Waterloo, Wisconsin. Her current practice location is
105 Highland Ter, Waterloo, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 478-2141.
Holly Keddington is licensed to practice in Wisconsin (license number 7947-23) 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 1194458794.
Provider's Profile
| Full Name | Holly Keddington |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 105 Highland Ter, Waterloo, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1194458794
- Provider Enumeration Date: 07/01/2022
- Last Update Date: 09/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577004993
- Enrollment ID: I20240925000759
Medical Identifiers
Medical identifiers for Holly Keddington such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194458794 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 7947-23 (Wisconsin) | 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. Holly Keddington allows following entities to bill medicare on her behalf.
| Entity Name | Dean Health Systems Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053358846
PECOS PAC ID: 7012827983
Enrollment ID: O20031105000584 |
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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. Holly Keddington 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 |
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Holly Keddington, PA-C
105 Highland Ter,
Waterloo, WI 53594-2217
Ph: (920) 478-2141 | Holly Keddington, PA-C
105 Highland Ter,
Waterloo, WI 53594-2217
Ph: (920) 478-2141 |
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