Kyle Cleasby, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fargo, North Dakota. His current practice location is
1919 Elm St N, Fargo, North Dakota. You can reach out to his office (for appointments etc.) via phone at
(701) 293-4113.
Kyle Cleasby 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 1093375370.
Physician's Profile
| Full Name | Kyle Cleasby |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1919 Elm St N, Fargo, North Dakota |
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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: 1093375370
- Provider Enumeration Date: 06/18/2019
- Last Update Date: 01/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 3173989522
- Enrollment ID: I20230510001235
Medical Identifiers
Medical identifiers for Kyle Cleasby such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093375370 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 18990 (North Dakota) | 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. Kyle Cleasby allows following entities to bill medicare on his behalf.
| Entity Name | Badlands Human Service Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124072525
PECOS PAC ID: 9739085499
Enrollment ID: O20031211000947 |
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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. Kyle Cleasby 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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Kyle Cleasby,
1463 I94 Business Loop E,
Dickinson, ND 58601-6434
Ph: (701) 227-7500 | Kyle Cleasby,
1919 Elm St N,
Fargo, ND 58102-2416
Ph: (701) 293-4113 |
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