Mr Roderick Kelly, PA - Medicare Physician Assistant in Fort Polk, LA

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Mr Roderick Kelly, PA is a medicare enrolled "Physician Assistant" in Fort Polk, Louisiana. He graduated from nursing school in 2000 and has 26 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Ward 3 4 And 10 Hospital Service District Of Parish Of Union, Concord Medical Group Pllc, Arklatex Medical Consultants A Medical Corporation, Concord Medical Group Of Texas Pllc, Concord Medical Group Pllc and his current practice location is 1585 3rd St, Fort Polk, Louisiana. You can reach out to his office (for appointments etc.) via phone at (337) 531-3011.

Mr Roderick Kelly is licensed to practice in Texas (license number PA02232) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1275637472.

Contact Information

Mr Roderick Kelly, PA
1585 3rd St,
Fort Polk, LA 71459-5102
(337) 531-3011
Not Available

Map and Direction




Provider's Profile

Full NameMr Roderick Kelly
GenderMale
SpecialityPhysician Assistant
Experience26 Years
Location1585 3rd St, Fort Polk, Louisiana
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Roderick Kelly graduated from nursing school in 2000
  NPI Data:
  • NPI Number: 1275637472
  • Provider Enumeration Date: 09/11/2006
  • Last Update Date: 09/16/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 6002912581
  • Enrollment ID: I20130725000750

Medical Identifiers

Medical identifiers for Mr Roderick Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275637472NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant PA200615 (Louisiana)Secondary
363A00000XPhysician Assistant PA02232 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Anson General HospitalAnson, TXHospital
Fmol Health St FrancisMonroe, LAHospital
Brownfield Regional Medical CenterBrownfield, TXHospital
Knox County HospitalKnox city, TXHospital
Beauregard Memorial HospitalDeridder, LAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Ward 3 4 And 10 Hospital Service District Of Parish Of Union812301113714
Concord Medical Group Pllc0446296818189
Arklatex Medical Consultants A Medical Corporation559700109916
Concord Medical Group Of Texas Pllc7810117223319
Concord Medical Group Pllc0446296818189

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. Mr Roderick Kelly allows following entities to bill medicare on his behalf.
Entity NameWard 3 4 & 10 Hospital Service District of Parish of Union
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124277728
PECOS PAC ID: 8123011137
Enrollment ID: O20040406000625
Entity NameNorthern Louisiana Emergency Physicians, LLP
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588828172
PECOS PAC ID: 9638246846
Enrollment ID: O20080930000036
Entity NameConcord Medical Group PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083630610
PECOS PAC ID: 0446296818
Enrollment ID: O20140930001176
Entity NameCross Lake Emergency Group, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013497114
PECOS PAC ID: 5395096440
Enrollment ID: O20180928000987
Entity NameArklatex Medical Consultants a Medical Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710466628
PECOS PAC ID: 5597001099
Enrollment ID: O20190103002111
Entity NameKisatchie Emergency Group LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235693847
PECOS PAC ID: 9537400270
Enrollment ID: O20190408001290
Entity NameMonroe Emergency Physicians LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386235331
PECOS PAC ID: 8820405079
Enrollment ID: O20210406000374

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 Roderick Kelly 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 AddressPractice Location Address
Mr Roderick Kelly, PA
1509 W Loop 281 Ste 2-b,
Longview, TX 75604-2820

Ph: (903) 759-9355		Mr Roderick Kelly, PA
1585 3rd St,
Fort Polk, LA 71459-5102

Ph: (337) 531-3011

Reviews and Comments


Physician Assistant Nurses in Fort Polk, LA

Mr. Mark Alexander Azel, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 46th Engineer Combat Battalion, Bldg. 2264, Suite 105, Fort Polk, LA 71459
Phone: 337-531-4233    
Joshua Mark Stipsits,
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St Bldg 285, Fort Polk, LA 71459
Phone: 726-780-2443    
Alexander Kenney, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 803-260-9993    
Mr. Samson Bekele Beshia, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 337-531-3118    
Mr. Garrett Simmons,
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: Bayne-jones Army Community Hospital 1585 Third St, Fort Polk, LA 71459
Phone: 318-840-3924    
Michael Davidson, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 337-531-3517    
Brian Richard Carlson, PHYSICIAN ASSISTANT
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 614-371-8434    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.