Kelly A Shields, LPC in Portland, OR - Medicare Counselor Provider

Kelly A Shields, LPC is a medicare enrolled "Counselor - Professional" provider in Portland, Oregon. Her current practice location is 5228 Ne Hoyt St, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 215-6474.

Kelly A Shields is licensed to practice in Oregon (license number C3406) 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 1083075790.

Contact Information

	Kelly A Shields, LPC
	5228 Ne Hoyt St, Portland, OR 97213-3055
	(503) 215-6474
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly A Shields
Gender	Female
Speciality	Counselor - Professional
Location	5228 Ne Hoyt St, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083075790
Provider Enumeration Date: 03/09/2016
Last Update Date: 01/03/2024

Medicare PECOS Information:

PECOS PAC ID: 1759733736
Enrollment ID: I20240115001783

Medical Identifiers

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

Identifier	Type	State	Issuer
1083075790	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	C3406 (Oregon)	Secondary
101YP2500X	Counselor - Professional	C3406 (Oregon)	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 A Shields allows following entities to bill medicare on her behalf.

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153

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 A Shields 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 A Shields, LPC Po Box 3395, Portland, OR 97208-3395 Ph: (503) 215-6474	Kelly A Shields, LPC 5228 Ne Hoyt St, Portland, OR 97213-3055 Ph: (503) 215-6474

Reviews and Comments

Counselor in Portland, OR

Deanna Gold, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 847 Ne 19th Ave, Suite 100, Portland, OR 97232 Phone: 503-891-9937
Loren Dale Horton, B.A, M.DIV. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1320 Sw Washington St, Portland, OR 97205 Phone: 503-535-1150
Michael Peter Kender, MA, M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 9111 Ne Sunderland Ave, Portland, OR 97211 Phone: 503-280-6646 Fax: 503-280-6051
Laura Ann Allen, MS, CADCIII Counselor Medicare: Not Enrolled in Medicare Practice Location: 324 Nw Davis St, Portland, OR 97209 Phone: 503-226-2203 Fax: 503-223-4231
James Paul Bryant, LCSW, CADC 3 Counselor Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-964-0000
Michael Ann Benchoff, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 421 Sw Oak Street, Suite 520, Portland, OR 97204 Phone: 503-988-4949
Lynn A Fontana, L.M.F.T, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 8035 Ne Prescott St, Portland, OR 97218 Phone: 503-223-7719 Fax: 503-255-4714

Kelly A Shields, LPC - Medicare Counselor in Portland, OR