Dr Scott W Kelley, MD is a medicare enrolled "Pathology - Dermatopathology" physician in Brookfield, Wisconsin. His current practice location is
12805 W Burleigh Rd, Suite 200, Brookfield, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 797-6434.
Dr Scott W Kelley is licensed to practice in Wisconsin (license number 36968) 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 1700863685.
Physician's Profile
| Full Name | Dr Scott W Kelley |
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| Gender | Male |
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| Speciality | Pathology - Dermatopathology |
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| Location | 12805 W Burleigh Rd, Brookfield, Wisconsin |
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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: 1700863685
- Provider Enumeration Date: 12/30/2005
- Last Update Date: 05/01/2015
Medicare PECOS Information:
- PECOS PAC ID: 6608784723
- Enrollment ID: I20051115000499
Medical Identifiers
Medical identifiers for Dr Scott W Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1700863685 | NPI | - | NPPES |
| 32649200 | Medicaid | WI | |
| 0540955 | Medicaid | IA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZD0900X | Pathology - Dermatopathology | 36968 (Wisconsin) | Primary |
| 207ZP0101X | Pathology - Anatomic Pathology | 36968 (Wisconsin) | Secondary |
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 Scott W Kelley allows following entities to bill medicare on his behalf.
| Entity Name | The Medical College Of Wisconsin Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699720086
PECOS PAC ID: 2668384371
Enrollment ID: O20031120000259 |
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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 Scott W Kelley 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 |
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Dr Scott W Kelley, MD
14275 Midway Rd, Suite 400,
Addison, TX 75001-3614
Ph: (214) 932-8029 | Dr Scott W Kelley, MD
12805 W Burleigh Rd, Suite 200,
Brookfield, WI 53005-3111
Ph: (262) 797-6434 |
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