Mrs Kelly Mitzen, PA-C is a medicare enrolled "Physician Assistant - Medical" in Fort Myer, Virginia. Her current practice location is
401 Carpenter Rd, Fort Myer, Virginia. You can reach out to her office (for appointments etc.) via phone at
(703) 966-7935.
Mrs Kelly Mitzen is licensed to practice in Virginia (license number 0110002992) 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 1073584777.
Provider's Profile
Full Name | Mrs Kelly Mitzen |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 401 Carpenter Rd, Fort Myer, Virginia |
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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: 1073584777
- Provider Enumeration Date: 01/30/2006
- Last Update Date: 07/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 1557509114
- Enrollment ID: I20130521000689
Medical Identifiers
Medical identifiers for Mrs Kelly Mitzen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073584777 | NPI | - | NPPES |
1073584777 | Other | | NPI |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 0110002992 (Virginia) | 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. Mrs Kelly Mitzen 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 Mitzen, PA-C 401 Carpenter Rd, Fort Myer, VA 22211-1009 Ph: () - | Mrs Kelly Mitzen, PA-C 401 Carpenter Rd, Fort Myer, VA 22211-1009 Ph: (703) 966-7935 |
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