Mrs Angela K Kelly, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Montpelier, Idaho. Her current practice location is
822 Washington St, Montpelier, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 847-4464.
Mrs Angela K Kelly is licensed to practice in Idaho (license number LCSW-35978) 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 1497015143.
Healthcare Provider's Profile
Full Name | Mrs Angela K Kelly |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 822 Washington St, Montpelier, Idaho |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497015143
- Provider Enumeration Date: 05/28/2012
- Last Update Date: 08/05/2016
Medicare PECOS Information:
- PECOS PAC ID: 0042591208
- Enrollment ID: I20161229001576
Medical Identifiers
Medical identifiers for Mrs Angela K Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497015143 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | LCSW-35978 (Idaho) | 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. Mrs Angela K Kelly allows following entities to bill medicare on her behalf.
Entity Name | Bear Lake County Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174741441 PECOS PAC ID: 5395799860 Enrollment ID: O20071003000677 |
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Entity Name | Life Change Associates Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598077562 PECOS PAC ID: 8224265574 Enrollment ID: O20131212001598 |
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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. Mrs Angela K Kelly 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 |
Mrs Angela K Kelly, LCSW 1675 Foxmore St, Pocatello, ID 83204-4677 Ph: (208) 317-2347 | Mrs Angela K Kelly, LCSW 822 Washington St, Montpelier, ID 83254-1423 Ph: (208) 847-4464 |
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