Kyle Shea, is a medicare enrolled "Speech-language Pathologist" provider in Glenwood City, Wisconsin. His current practice location is
612 E Oak St, Glenwood City, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 265-4325.
Kyle Shea is licensed to practice in Wisconsin (license number 4153-154) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285019422.
Healthcare Provider's Profile
| Full Name | Kyle Shea |
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| Gender | Male |
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| Speciality | Speech-language Pathologist |
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| Location | 612 E Oak St, Glenwood City, Wisconsin |
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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: 1285019422
- Provider Enumeration Date: 07/29/2015
- Last Update Date: 07/29/2015
Medicare PECOS Information:
- PECOS PAC ID: 1850821646
- Enrollment ID: I20250210000353
Medical Identifiers
Medical identifiers for Kyle Shea such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1285019422 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 4153-154 (Wisconsin) | 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. Kyle Shea allows following entities to bill medicare on his behalf.
| Provider Name | Paxxon Healthcare Services Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1003174087
PECOS PAC ID: 8325959554
Enrollment ID: O20130917000750 |
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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. Kyle Shea 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 |
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Kyle Shea,
2510 W Princeton Ave,
Eau Claire, WI 54703-3784
Ph: (715) 379-6323 | Kyle Shea,
612 E Oak St,
Glenwood City, WI 54013-8520
Ph: (715) 265-4325 |
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