Miss Kelly Jean Hall, DPM is a medicare enrolled "Podiatrist" provider in Bothell, Washington. She went to California School Of Podiatric Medicine and graduated in 1996 and has 29 years of diverse experience with area of expertise as Podiatry. Her current practice location is
12900 Ne 180th St Ste 150, Bothell, Washington. You can reach out to her office (for appointments etc.) via phone at
(206) 365-5484.
Miss Kelly Jean Hall is licensed to practice in Washington (license number PO00000617) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1205932191.
Healthcare Provider's Profile
| Full Name | Miss Kelly Jean Hall |
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| Gender | Female |
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| Speciality | Podiatry |
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| Experience | 29 Years |
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| Location | 12900 Ne 180th St Ste 150, Bothell, Washington |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Miss Kelly Jean Hall attended and graduated from California School Of Podiatric Medicine in 1996
NPI Data:
- NPI Number: 1205932191
- Provider Enumeration Date: 09/16/2006
- Last Update Date: 08/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 9436275518
- Enrollment ID: I20100927000271
Medical Identifiers
Medical identifiers for Miss Kelly Jean Hall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205932191 | NPI | - | NPPES |
| 1106699 | Medicaid | WA | |
| 5815682 | Other | WA | AETNA |
| HA0967 | Other | WA | REGENCE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | PO00000617 (Washington) | 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 Kelly Jean Hall allows following entities to bill medicare on her behalf.
| Provider Name | Northwest Foot And Ankle Specialists Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1790337194
PECOS PAC ID: 5597198390
Enrollment ID: O20191210000343 |
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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. Miss Kelly Jean Hall 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 |
|---|
Miss Kelly Jean Hall, DPM
12900 Ne 180th St Ste 150,
Bothell, WA 98011-5778
Ph: (206) 365-5484 | Miss Kelly Jean Hall, DPM
12900 Ne 180th St Ste 150,
Bothell, WA 98011-5778
Ph: (206) 365-5484 |
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