Mrs Kelly Marie Rudroff, RN, MSN in Saint Louis, MO

Mrs Kelly Marie Rudroff, RN, MSN is a medicare enrolled "Nurse Practitioner - Family" in Saint Louis, Missouri. Her current practice location is 915 N Grand Blvd, Saint Louis, Missouri. You can reach out to her office (for appointments etc.) via phone at (314) 652-4100.

Mrs Kelly Marie Rudroff is licensed to practice in Missouri (license number 2016042952) 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 1609216159.

Contact Information

	Mrs Kelly Marie Rudroff, RN, MSN
	915 N Grand Blvd, Saint Louis, MO 63106
	(314) 652-4100
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kelly Marie Rudroff
Gender	Female
Speciality	Nurse Practitioner - Family
Location	915 N Grand Blvd, Saint Louis, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609216159
Provider Enumeration Date: 06/28/2013
Last Update Date: 04/14/2018

Medicare PECOS Information:

PECOS PAC ID: 1557625696
Enrollment ID: I20241115001960

Medical Identifiers

Medical identifiers for Mrs Kelly Marie Rudroff such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609216159	NPI	-	NPPES
1609216159	Other	MO	UNSURE OF ISSUER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	2016042952 (Missouri)	Primary
163W00000X	Registered Nurse	900243 (Mississippi)	Secondary

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. Mrs Kelly Marie Rudroff allows following entities to bill medicare on her behalf.

Entity Name	Vpa Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760706337 PECOS PAC ID: 9234041948 Enrollment ID: O20100818000518

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. Mrs Kelly Marie Rudroff 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
Mrs Kelly Marie Rudroff, RN, MSN 2909 Shenandoah Ave, Saint Louis, MO 63104-1739 Ph: (314) 583-7698	Mrs Kelly Marie Rudroff, RN, MSN 915 N Grand Blvd, Saint Louis, MO 63106 Ph: (314) 652-4100

Reviews and Comments

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Mrs Kelly Marie Rudroff, RN, MSN - Medicare Nurse Practitioner in Saint Louis, MO