Kylee Goddard, OD is a medicare enrolled "Optometrist" provider in Kimberling City, Missouri. Her current practice location is
1 Woodland Ave, Kimberling City, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 739-2411.
Kylee Goddard is licensed to practice in Missouri (license number T03116) 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 1255916052.
Healthcare Provider's Profile
| Full Name | Kylee Goddard |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 1 Woodland Ave, Kimberling City, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1255916052
- Provider Enumeration Date: 03/12/2021
- Last Update Date: 03/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 7618371303
- Enrollment ID: I20210803000428
Medical Identifiers
Medical identifiers for Kylee Goddard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255916052 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | T03116 (Missouri) | 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. Kylee Goddard allows following entities to bill medicare on her behalf.
| Provider Name | Springfield Eyecare, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1730370305
PECOS PAC ID: 9234105008
Enrollment ID: O20040903000133 |
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| Provider Name | Kimberling Vision Center, Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1417001009
PECOS PAC ID: 5395703680
Enrollment ID: O20050104000003 |
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| Provider Name | Doctors Onsite Eyecare, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1770763831
PECOS PAC ID: 1759470701
Enrollment ID: O20090112000560 |
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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. Kylee Goddard 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 |
|---|
Kylee Goddard, OD
1 Woodland Ave,
Kimberling City, MO 65686-9738
Ph: (417) 739-2411 | Kylee Goddard, OD
1 Woodland Ave,
Kimberling City, MO 65686-9738
Ph: (417) 739-2411 |
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