Dr Mary Ellen Kenworthy, DO - Medicare Emergency Medicine in Pontiac, MI

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Dr Mary Ellen Kenworthy, DO is a medicare enrolled "Emergency Medicine" physician in Pontiac, Michigan. She graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Western Virginia Regional Emergency Physicians Llc, Tri-cities Regional Emergency Physicians, Pc and her current practice location is 50 North Perry Street, Pontiac, Michigan. You can reach out to her office (for appointments etc.) via phone at (276) 223-8350.

Dr Mary Ellen Kenworthy is licensed to practice in Tennessee (license number 3444) 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 1205123361.

Contact Information

Dr Mary Ellen Kenworthy, DO
50 North Perry Street,
Pontiac, MI 48342
(276) 223-8350
Not Available

Map and Direction




Physician's Profile

Full NameDr Mary Ellen Kenworthy
GenderFemale
SpecialityEmergency Medicine
Experience13 Years
Location50 North Perry Street, Pontiac, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Mary Ellen Kenworthy graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1205123361
  • Provider Enumeration Date: 07/08/2011
  • Last Update Date: 07/29/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 6608010863
  • Enrollment ID: I20160805000791

Medical Identifiers

Medical identifiers for Dr Mary Ellen Kenworthy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205123361NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 3444 (Tennessee)Primary
207P00000XEmergency Medicine 0102204478 (Virginia)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Johnson County Community HospitalMountain city, TNHospital
Dickenson Community HospitalClintwood, VAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Western Virginia Regional Emergency Physicians Llc418399122775
Tri-cities Regional Emergency Physicians, Pc3678859477127

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 Mary Ellen Kenworthy allows following entities to bill medicare on her behalf.
Entity NameSouthwestern Virginia Mental Health Institute
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912964347
PECOS PAC ID: 3577571041
Enrollment ID: O20060324000094
Entity NameWestern Virginia Regional Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386183028
PECOS PAC ID: 4183991227
Enrollment ID: O20170522001368

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 Mary Ellen Kenworthy 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 AddressPractice Location Address
Dr Mary Ellen Kenworthy, DO
50 North Perry Street,
Pontiac, MI 48342

Ph: (248) 338-5393		Dr Mary Ellen Kenworthy, DO
50 North Perry Street,
Pontiac, MI 48342

Ph: (276) 223-8350

Reviews and Comments


Emergency Medicine Doctors in Pontiac, MI

Dr. Michael Christopher Dettloff, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 50 N Perry St, Pontiac, MI 48342
Phone: 248-338-5000    
Dr. William M. Serote, D.O.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 461 W Huron St, Nomc Emercency Center, Pontiac, MI 48341
Phone: 248-857-7440    Fax: 248-857-6992
Dr. Jennifer Ann Freij, D.O
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 44405 Woodward Ave, Pontiac, MI 48341
Phone: 248-858-3000    
Dr. David Anthony Minter, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 50 N Perry St, Pontiac, MI 48342
Phone: 248-338-5000    
Dr. Alexander Samuel Madgy, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 44405 Woodward Ave, Pontiac, MI 48341
Phone: 248-849-3485    
Dr. Phillip J. Masterson, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 461 W Huron St, Nomc Emergency Center, Pontiac, MI 48341
Phone: 248-857-7440    Fax: 248-857-6992
R Steven Hemby, DO
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 50 N Perry St, Pontiac, MI 48342
Phone: 248-338-5327    Fax: 248-338-5129

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.