Kyle D Kiesewetter, in Peoria, IL - Medicare Clinical Nurse Specialist

Kyle D Kiesewetter, is a medicare enrolled "Clinical Nurse Specialist - Gerontology" in Peoria, Illinois. His current practice location is 221 Ne Glen Oak Ave, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 672-4859.

Kyle D Kiesewetter is licensed to practice in Illinois (license number 209.020932) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1598399693.

Contact Information

	Kyle D Kiesewetter,
	221 Ne Glen Oak Ave, Peoria, IL 61636-0001
	(309) 672-4859
	Not Available

Map and Direction

Provider's Profile

Full Name	Kyle D Kiesewetter
Gender	Male
Speciality	Clinical Nurse Specialist - Gerontology
Location	221 Ne Glen Oak Ave, Peoria, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598399693
Provider Enumeration Date: 02/27/2020
Last Update Date: 02/27/2020

Medicare PECOS Information:

PECOS PAC ID: 6608206735
Enrollment ID: I20200414000094

Medical Identifiers

Medical identifiers for Kyle D Kiesewetter such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598399693	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
364SG0600X	Clinical Nurse Specialist - Gerontology	209.020932 (Illinois)	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. Kyle D Kiesewetter allows following entities to bill medicare on his behalf.

Entity Name	Methodist Medical Center Of Illinois
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494

Entity Name	Proctor Health Systems
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134173917 PECOS PAC ID: 3476440173 Enrollment ID: O20040227000906

Entity Name	Methodist Medical Center Of Illinois
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184670663 PECOS PAC ID: 1355259714 Enrollment ID: O20040315000196

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. Kyle D Kiesewetter 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
Kyle D Kiesewetter, 1210 N Old Trail Rd, East Peoria, IL 61611-1212 Ph: (309) 264-1234	Kyle D Kiesewetter, 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 Ph: (309) 672-4859

Reviews and Comments

Clinical Nurse Specialist Nurses in Peoria, IL

Cheryl Herrmann, Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 112 Ne Crescent Ave, Peoria, IL 61606 Phone: 309-672-4670
Ms. Colleen Susanne Cushing Ragon, APN, CNS Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 8940 N Wood Sage Rd, Peoria, IL 61615 Phone: 309-243-3000 Fax: 309-243-3274
Mrs. Heather A Boore, APN, CNS-BC Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 Phone: 309-624-9844
Mrs. Jessica M Stewart, CNS Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 8940 N Wood Sage Rd, Peoria, IL 61615 Phone: 309-243-3000 Fax: 309-243-3215
Mckenzie Regan Likes, APN-C Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5522
Sarah E Dominique, APN CDE Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-2480
Melissa R Norris, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 3525 N University St, Peoria, IL 61604 Phone: 309-886-9172 Fax: 309-509-4045

Kyle D Kiesewetter, - Medicare Clinical Nurse Specialist in Peoria, IL