Mrs Tara Marie Kelly, NP in Merrick, NY - Medicare Nurse Practitioner

Mrs Tara Marie Kelly, NP is a medicare enrolled "Nurse Practitioner - Family" in Merrick, New York. Her current practice location is 2119 Merrick Rd, Merrick, New York. You can reach out to her office (for appointments etc.) via phone at (516) 377-2820.

Mrs Tara Marie Kelly is licensed to practice in New York (license number 347883) 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 1508503632.

Contact Information

	Mrs Tara Marie Kelly, NP
	2119 Merrick Rd, Merrick, NY 11566-4704
	(516) 377-2820
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Tara Marie Kelly
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2119 Merrick Rd, Merrick, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1508503632
Provider Enumeration Date: 05/19/2022
Last Update Date: 06/04/2022

Medicare PECOS Information:

PECOS PAC ID: 7810373685
Enrollment ID: I20220930002091

Medical Identifiers

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

Identifier	Type	State	Issuer
1508503632	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	347883 (New York)	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. Mrs Tara Marie Kelly allows following entities to bill medicare on her behalf.

Entity Name	North Shore-lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

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 Tara Marie 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 Address	Practice Location Address
Mrs Tara Marie Kelly, NP 2119 Merrick Rd, Merrick, NY 11566-4704 Ph: (516) 377-2820	Mrs Tara Marie Kelly, NP 2119 Merrick Rd, Merrick, NY 11566-4704 Ph: (516) 377-2820

Reviews and Comments

Nurse Practitioner Nurses in Merrick, NY

Dana Ahern Flick, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2119 Merrick Rd, Merrick, NY 11566 Phone: 516-377-2820
Susu Huang, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2094 Merrick Ave, Merrick, NY 11566 Phone: 516-600-0676 Fax: 516-863-2963
Sumra Khan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 31 Merrick Ave Ste 10, Merrick, NY 11566 Phone: 516-771-9797
Galia Bagdasarov, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2079 Lawry Ln, Merrick, NY 11566 Phone: 516-851-0817
Marygrace E Colucci, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1703 Merrick Ave, Merrick, NY 11566 Phone: 516-378-3311 Fax: 516-546-1517
Mr. Michael C Poliseno, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2094 Merrick Ave, Merrick, NY 11566 Phone: 516-375-5904 Fax: 516-804-2784
Mrs. Christina Scavo, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 31 Merrick Ave Ste 10, Merrick, NY 11566 Phone: 516-776-8062 Fax: 888-608-7845

Mrs Tara Marie Kelly, NP - Medicare Nurse Practitioner in Merrick, NY