Miss Kelley Nicole Tate, PT - Medicare Physical Therapist in Boonville, MO

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Miss Kelley Nicole Tate, PT is a medicare enrolled "Physical Therapist" provider in Boonville, Missouri. Her current practice location is 1420 W Ashley Rd, Boonville, Missouri. You can reach out to her office (for appointments etc.) via phone at (660) 882-6115.

Miss Kelley Nicole Tate is licensed to practice in Missouri (license number 2002025550) 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 1003811258.

Contact Information

Miss Kelley Nicole Tate, PT
1420 W Ashley Rd,
Boonville, MO 65233-2112
(660) 882-6115
(660) 882-6120

Map and Direction




Healthcare Provider's Profile

Full NameMiss Kelley Nicole Tate
GenderFemale
SpecialityPhysical Therapist
Location1420 W Ashley Rd, Boonville, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003811258
  • Provider Enumeration Date: 06/15/2005
  • Last Update Date: 02/20/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0446424204
  • Enrollment ID: I20111114000666

Medical Identifiers

Medical identifiers for Miss Kelley Nicole Tate such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003811258NPI-NPPES
484700802MedicaidMO
650025700OtherMOMEDICARE RAILROAD
122566OtherMOBCBS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist 2002025550 (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. Miss Kelley Nicole Tate allows following entities to bill medicare on her behalf.
Provider NameEmpowerme Rehabilitation Missouri Llc
Provider TypePart B Supplier - Physical/occupational Therapy Group In Private Practice
Provider IdentifiersNPI Number: 1417479494
PECOS PAC ID: 9234402470
Enrollment ID: O20170908002930
Provider NameEmpowerme Wellness Kansas City Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1083208391
PECOS PAC ID: 9830504836
Enrollment ID: O20210308002804

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. Miss Kelley Nicole Tate 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
Miss Kelley Nicole Tate, PT
4501 S Harvest Rd,
Columbia, MO 65203-8764

Ph: (573) 474-5098		Miss Kelley Nicole Tate, PT
1420 W Ashley Rd,
Boonville, MO 65233-2112

Ph: (660) 882-6115

Reviews and Comments


Physical Therapist in Boonville, MO

Reorganized School District No 1
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 736 Main St, Boonville, MO 65233
Phone: 660-882-7474    Fax: 660-882-5721
Elyssa Ann Gibbons, DPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1731 Daniel Boone Ln, Boonville, MO 65233
Phone: 660-537-3908    
Timothy R Tracy, D.P.T
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1420 W Ashley Rd, Boonville, MO 65233
Phone: 660-882-6115    
Excel Physical Therapy & Sports Medicine Clinic
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1420 W Ashley Rd, Boonville, MO 65233
Phone: 660-882-6115    Fax: 660-882-6120
Mrs. Jennifer Jo Hackman, P.T. ,A.T.C.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1420 W Ashley Rd, Boonville, MO 65233
Phone: 660-882-6115    Fax: 660-882-6120

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.