Mrs Michelle Leigh Endicott, DO is a medicare enrolled "Dermatology" physician in South Charleston, West Virginia. She went to West Virginia School Of Osteopathic Medicine and graduated in 2001 and has 24 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Mountain State Medical Specialties Pllc and her current practice location is
4815 Kanawha Ave Sw, South Charleston, West Virginia. You can reach out to her office (for appointments etc.) via phone at
(304) 768-4567.
Mrs Michelle Leigh Endicott is licensed to practice in West Virginia (license number 2097) 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 1699774315.
Physician's Profile
Full Name | Mrs Michelle Leigh Endicott |
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Gender | Female |
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Speciality | Dermatology |
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Experience | 24 Years |
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Location | 4815 Kanawha Ave Sw, South Charleston, West Virginia |
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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. |
Medical Education and Training:
- Mrs Michelle Leigh Endicott attended and graduated from West Virginia School Of Osteopathic Medicine in 2001
NPI Data:
- NPI Number: 1699774315
- Provider Enumeration Date: 07/14/2005
- Last Update Date: 09/11/2012
Medicare PECOS Information:
- PECOS PAC ID: 2769410497
- Enrollment ID: I20050805000839
Medical Identifiers
Medical identifiers for Mrs Michelle Leigh Endicott such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699774315 | NPI | - | NPPES |
3810002529 | Medicaid | WV | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | 2097 (West Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Mountain State Medical Specialties Pllc | 9335046754 | 33 |
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. Mrs Michelle Leigh Endicott allows following entities to bill medicare on her behalf.
Entity Name | Mountain State Medical Specialties Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1891892097 PECOS PAC ID: 9335046754 Enrollment ID: O20040308000599 |
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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. Mrs Michelle Leigh Endicott 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 |
Mrs Michelle Leigh Endicott, DO 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 Ph: (304) 768-4567 | Mrs Michelle Leigh Endicott, DO 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 Ph: (304) 768-4567 |
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