Kelly Diane Tepedino, MD is a medicare enrolled "Dermatology" physician in Lake City, Florida. She went to University Of Florida College Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice North Florida Dermatology Llc and her current practice location is
1722 Sw Newland Way, Lake City, Florida. You can reach out to her office (for appointments etc.) via phone at
(386) 344-6102.
Kelly Diane Tepedino is licensed to practice in Florida (license number ME122956) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1619237369.
Physician's Profile
| Full Name | Kelly Diane Tepedino |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 12 Years |
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| Location | 1722 Sw Newland Way, Lake City, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly Diane Tepedino attended and graduated from University Of Florida College Of Medicine in 2012
NPI Data:
- NPI Number: 1619237369
- Provider Enumeration Date: 05/29/2012
- Last Update Date: 03/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355579806
- Enrollment ID: I20160929001697
Medical Identifiers
Medical identifiers for Kelly Diane Tepedino such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619237369 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | ME122956 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| North Florida Dermatology Llc | 9830486166 | 2 |
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 Diane Tepedino allows following entities to bill medicare on her behalf.
| Entity Name | North Florida Dermatology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689023830
PECOS PAC ID: 9830486166
Enrollment ID: O20160929001645 |
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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. Kelly Diane Tepedino 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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Kelly Diane Tepedino, MD
1722 Sw Newland Way,
Lake City, FL 32025-6915
Ph: (386) 344-6102 | Kelly Diane Tepedino, MD
1722 Sw Newland Way,
Lake City, FL 32025-6915
Ph: (386) 344-6102 |
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