Dr Kenneth Bruce Quenneville, MD is a medicare enrolled "Emergency Medicine" physician in Memphis, Missouri. His current practice location is
12000 County Road 801, Memphis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(660) 988-1296.
Dr Kenneth Bruce Quenneville is licensed to practice in Missouri (license number 2009029477) 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 1174591556.
Physician's Profile
| Full Name | Dr Kenneth Bruce Quenneville |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 12000 County Road 801, Memphis, Missouri |
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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: 1174591556
- Provider Enumeration Date: 03/10/2006
- Last Update Date: 10/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 3779579800
- Enrollment ID: I20100105000691
Medical Identifiers
Medical identifiers for Dr Kenneth Bruce Quenneville such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174591556 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 39876 (Iowa) | Secondary |
| 208D00000X | General Practice | 2009029477 (Missouri) | Secondary |
| 207P00000X | Emergency Medicine | 2009029477 (Missouri) | 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. Dr Kenneth Bruce Quenneville allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689158487
PECOS PAC ID: 3274895263
Enrollment ID: O20210212002068 |
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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. Dr Kenneth Bruce Quenneville 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 |
|---|
Dr Kenneth Bruce Quenneville, MD
12000 County Road 801,
Memphis, MO 63555-2024
Ph: (660) 988-1296 | Dr Kenneth Bruce Quenneville, MD
12000 County Road 801,
Memphis, MO 63555-2024
Ph: (660) 988-1296 |
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