Kelly Kirsten O'malia, MD is a medicare enrolled "Family Medicine" physician in Bristolville, Ohio. Her current practice location is
6265 State Route 45, Bristolville, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 889-9009.
Kelly Kirsten O'malia is licensed to practice in Ohio (license number 35073030) 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 1376546697.
Physician's Profile
| Full Name | Kelly Kirsten O'malia |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 6265 State Route 45, Bristolville, Ohio |
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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: 1376546697
- Provider Enumeration Date: 05/31/2005
- Last Update Date: 02/11/2009
Medicare PECOS Information:
- PECOS PAC ID: 5890712343
- Enrollment ID: I20051025000265
Medical Identifiers
Medical identifiers for Kelly Kirsten O'malia such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376546697 | NPI | - | NPPES |
| 835645 | Other | OH | CIGNA |
| PO0020658 | Other | OH | RAILROAD MEDICARE |
| 000000284981 | Other | OH | ANTHEM BLUE CROSS BLUE SH |
| 5300780 | Other | OH | AETNA |
| 2122385 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 35073030 (Ohio) | 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 Kirsten O'malia allows following entities to bill medicare on her behalf.
| Entity Name | University Hospitals Urgent Care, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124765052
PECOS PAC ID: 3971985607
Enrollment ID: O20220727004332 |
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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 Kirsten O'malia 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 Kirsten O'malia, MD
6265 State Route 45, Po Box 280,
Bristolville, OH 44402-0280
Ph: (330) 889-9009 | Kelly Kirsten O'malia, MD
6265 State Route 45,
Bristolville, OH 44402
Ph: (330) 889-9009 |
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