Theresa Katherine Mattingly, MD in Lees Summit, MO

Theresa Katherine Mattingly, MD is a medicare enrolled "Dermatology" physician in Lees Summit, Missouri. She went to Saint Louis University School Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Advanced Dermatology Of Southeast Missouri Pc and her current practice location is 3265 Ne Ralph Powell Rd, Lees Summit, Missouri. You can reach out to her office (for appointments etc.) via phone at (816) 524-4747.

Theresa Katherine Mattingly is licensed to practice in Illinois (license number 125064953) 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 1265849053.

Contact Information

	Theresa Katherine Mattingly, MD
	3265 Ne Ralph Powell Rd, Lees Summit, MO 64064-2301
	(816) 524-4747
	(816) 524-4929

Map and Direction

Physician's Profile

Full Name	Theresa Katherine Mattingly
Gender	Female
Speciality	Dermatology
Experience	10 Years
Location	3265 Ne Ralph Powell Rd, Lees Summit, Missouri
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:

Theresa Katherine Mattingly attended and graduated from Saint Louis University School Of Medicine in 2014

NPI Data:

NPI Number: 1265849053
Provider Enumeration Date: 07/14/2014
Last Update Date: 02/08/2021

Medicare PECOS Information:

PECOS PAC ID: 6103120902
Enrollment ID: I20180720000298

Medical Identifiers

Medical identifiers for Theresa Katherine Mattingly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265849053	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	125064953 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Southeasthealth	Cape girardeau, MO	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Advanced Dermatology Of Southeast Missouri Pc	3678612108	9

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. Theresa Katherine Mattingly allows following entities to bill medicare on her behalf.

Entity Name	Dermatology And Skin Cancer Specialists Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205880846 PECOS PAC ID: 5294721486 Enrollment ID: O20040422001277

Entity Name	Advanced Dermatology Of Southeast Missouri Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770713950 PECOS PAC ID: 3678612108 Enrollment ID: O20091123000348

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. Theresa Katherine Mattingly 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
Theresa Katherine Mattingly, MD 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064-2301 Ph: (816) 524-4747	Theresa Katherine Mattingly, MD 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064-2301 Ph: (816) 524-4747

Reviews and Comments

Dermatology Doctors in Lees Summit, MO

Nicholas Joseph Golda, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064 Phone: 913-907-2496
Julie Ann Green, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064 Phone: 913-451-7546 Fax: 816-524-4929
Grant Jeffrey Randall, MD Dermatology Medicare: Medicare Enrolled Practice Location: 601 Nw Obrien Rd, Lees Summit, MO 64063 Phone: 816-287-1528 Fax: 343-503-0640
Sheldon Sebastian, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064 Phone: 816-524-4747 Fax: 816-524-4929
David Ryan Fieleke, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1728 Ne Nine Oaks Dr, Lees Summit, MO 64086 Phone: 573-356-7265
Dr. Brea Nicole Sturm, MD Dermatology Medicare: Medicare Enrolled Practice Location: 601 Nw Obrien Rd, Lees Summit, MO 64063 Phone: 816-287-1528 Fax: 816-287-1528

Theresa Katherine Mattingly, MD - Medicare Dermatology in Lees Summit, MO