Colin David Kavanaugh, MD in Belleville, WI - Medicare Student in an Organized Health Care Education/Training Program

Colin David Kavanaugh, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Belleville, Wisconsin. His current practice location is 1121 Bellwest Blvd, Belleville, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (608) 424-3384.

Colin David Kavanaugh is licensed to practice in * (Not Available) (license number ) 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 1841871241.

Contact Information

	Colin David Kavanaugh, MD
	1121 Bellwest Blvd, Belleville, WI 53508-9433
	(608) 424-3384
	(608) 424-6353

Map and Direction

Physician's Profile

Full Name	Colin David Kavanaugh
Gender	Male
Speciality	Student In An Organized Health Care Education/training Program
Location	1121 Bellwest Blvd, Belleville, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1841871241
Provider Enumeration Date: 04/16/2021
Last Update Date: 03/15/2023

Medicare PECOS Information:

PECOS PAC ID: 3577964543
Enrollment ID: I20230329000370

Medical Identifiers

Medical identifiers for Colin David Kavanaugh such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841871241	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	77586 (Wisconsin)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	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. Colin David Kavanaugh allows following entities to bill medicare on his behalf.

Entity Name	The Monroe Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386720548 PECOS PAC ID: 3072425495 Enrollment ID: O20031104000392

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. Colin David Kavanaugh 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
Colin David Kavanaugh, MD 1121 Bellwest Blvd, Belleville, WI 53508-9433 Ph: (608) 424-3384	Colin David Kavanaugh, MD 1121 Bellwest Blvd, Belleville, WI 53508-9433 Ph: (608) 424-3384

Colin David Kavanaugh, MD - Medicare Student in an Organized Health Care Education/Training Program in Belleville, WI