Mr Kevin Michael Fordell, PA is a medicare enrolled "Emergency Medicine" in Mesa, Arizona. His current practice location is
2550 N Thunderbird Cir Ste 303, Mesa, Arizona. You can reach out to his office (for appointments etc.) via phone at
(480) 924-8382.
Mr Kevin Michael Fordell is licensed to practice in Arizona (license number 4295) 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 1417107822.
Provider's Profile
| Full Name | Mr Kevin Michael Fordell |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 2550 N Thunderbird Cir Ste 303, Mesa, Arizona |
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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: 1417107822
- Provider Enumeration Date: 09/22/2008
- Last Update Date: 03/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 0749342772
- Enrollment ID: I20081229000283
Medical Identifiers
Medical identifiers for Mr Kevin Michael Fordell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417107822 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | 4295 (Arizona) | Secondary |
| 207P00000X | Emergency Medicine | 4295 (Arizona) | Primary |
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. Mr Kevin Michael Fordell 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 |
Mr Kevin Michael Fordell, PA 645 E Missouri Ave Ste 300, Phoenix, AZ 85012-1351 Ph: (602) 502-4621 | Mr Kevin Michael Fordell, PA 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 Ph: (480) 924-8382 |
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