Georgia Kelly-williams, - Medicare Nurse Practitioner in Deer Park, NY

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Georgia Kelly-williams, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Deer Park, New York. Her current practice location is 52 Tiber Ave, Deer Park, New York. You can reach out to her office (for appointments etc.) via phone at (631) 404-8843.

Georgia Kelly-williams is licensed to practice in New York (license number 404380) 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 1104545037.

Contact Information

Georgia Kelly-williams,
52 Tiber Ave,
Deer Park, NY 11729-7012
(631) 404-8843
Not Available

Map and Direction




Provider's Profile

Full NameGeorgia Kelly-williams
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location52 Tiber Ave, Deer Park, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104545037
  • Provider Enumeration Date: 08/24/2022
  • Last Update Date: 08/24/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8224400262
  • Enrollment ID: I20230221000678

Medical Identifiers

Medical identifiers for Georgia Kelly-williams such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104545037NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 404380 (New York)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. Georgia Kelly-williams allows following entities to bill medicare on her behalf.
Entity NameCs Medical Associates, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992210231
PECOS PAC ID: 9335401454
Enrollment ID: O20180329000208
Entity NameSupportive Care Psychology Of Ny Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104315068
PECOS PAC ID: 0749536852
Enrollment ID: O20180703001311

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. Georgia Kelly-williams 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
Georgia Kelly-williams,
52 Tiber Ave,
Deer Park, NY 11729-7012

Ph: (631) 404-8843		Georgia Kelly-williams,
52 Tiber Ave,
Deer Park, NY 11729-7012

Ph: (631) 404-8843

Reviews and Comments


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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.