Kelly Connolly, LICSW in Coon Rapids, MN - Medicare Social Worker Provider

Kelly Connolly, LICSW is a medicare enrolled "Social Worker" provider in Coon Rapids, Minnesota. Her current practice location is 3960 Coon Rapids Blvd Nw Ste 200, Coon Rapids, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 236-9236.

Kelly Connolly is licensed to practice in Minnesota (license number 25205) 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 1487381091.

Contact Information

	Kelly Connolly, LICSW
	3960 Coon Rapids Blvd Nw Ste 200, Coon Rapids, MN 55433-2589
	(763) 236-9236
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Connolly
Gender	Female
Speciality	Social Worker
Location	3960 Coon Rapids Blvd Nw Ste 200, Coon Rapids, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487381091
Provider Enumeration Date: 08/03/2022
Last Update Date: 01/17/2023

Medicare PECOS Information:

PECOS PAC ID: 8628445558
Enrollment ID: I20221107002698

Medical Identifiers

Medical identifiers for Kelly Connolly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487381091	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	25205 (Minnesota)	Secondary
104100000X	Social Worker	25205 (Minnesota)	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. Kelly Connolly allows following entities to bill medicare on her behalf.

Entity Name	Allina Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295272342 PECOS PAC ID: 4587573613 Enrollment ID: O20040319000460

Entity Name	Allina Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457657249 PECOS PAC ID: 4587573613 Enrollment ID: O20221213001713

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. Kelly Connolly 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
Kelly Connolly, LICSW 3960 Coon Rapids Blvd Nw Ste 200, Coon Rapids, MN 55433-2589 Ph: () -	Kelly Connolly, LICSW 3960 Coon Rapids Blvd Nw Ste 200, Coon Rapids, MN 55433-2589 Ph: (763) 236-9236

Reviews and Comments

Social Worker in Coon Rapids, MN

Blythe Ellen Nelson, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 763-780-9155
Angela Ronay, M.S.W, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10081 Dogwood St Nw, Suite 100, Coon Rapids, MN 55448 Phone: 763-783-3722 Fax: 763-783-7944
Jennifer Andrews, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 9120 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 612-400-6121
Elizabeth Anne Johnson, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 763-780-9155 Fax: 763-236-1066
Alexa Benevides Mcdermid, MSW, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 199 Coon Rapids Blvd Nw Ste 208, Coon Rapids, MN 55433 Phone: 952-491-0730
Mr. Joseph John Wittenberg, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11220 Crocus St Nw, Coon Rapids, MN 55433 Phone: 763-767-4702
Richard Alan Wandersee, MSW LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11475 Robinson Dr Nw, Mail Stop 32600a, Coon Rapids, MN 55433 Phone: 763-754-4600 Fax: 763-754-4614

Kelly Connolly, LICSW - Medicare Clinical Social Worker in Coon Rapids, MN