Kelly Tull, WHNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Fiskdale, Massachusetts. Her current practice location is
22 North Dr, Fiskdale, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(812) 236-7743.
Kelly Tull is licensed to practice in Massachusetts (license number RN2323729) 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 1306398409.
Provider's Profile
| Full Name | Kelly Tull |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Women's Health |
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| Location | 22 North Dr, Fiskdale, Massachusetts |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1306398409
- Provider Enumeration Date: 10/25/2016
- Last Update Date: 08/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 3476834359
- Enrollment ID: I20200805002147
Medical Identifiers
Medical identifiers for Kelly Tull such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1306398409 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LW0102X | Nurse Practitioner - Women's Health | 7658 (Connecticut) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | 28185781A (Indiana) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | RN2323729 (Massachusetts) | 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 Tull allows following entities to bill medicare on her behalf.
| Entity Name | Baystate Ob/gyn Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366542342 PECOS PAC ID: 1153392659 Enrollment ID: O20040805001003 |
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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. Kelly Tull 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 Tull, WHNP 22 North Dr, Fiskdale, MA 01518-1161 Ph: (812) 236-7743 | Kelly Tull, WHNP 22 North Dr, Fiskdale, MA 01518-1161 Ph: (812) 236-7743 |
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