Kelcy Wiley, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Dummerston, Vermont. Her current practice location is
1 Anna Marsh Ln, Dummerston, Vermont. You can reach out to her office (for appointments etc.) via phone at
(410) 463-9418.
Kelcy Wiley is licensed to practice in Maryland (license number R182450) 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 1508246695.
Provider's Profile
Full Name | Kelcy Wiley |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 1 Anna Marsh Ln, Dummerston, Vermont |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508246695
- Provider Enumeration Date: 06/03/2015
- Last Update Date: 08/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860795804
- Enrollment ID: I20190404002493
Medical Identifiers
Medical identifiers for Kelcy Wiley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508246695 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | CNP151191 (Maine) | Secondary |
363LF0000X | Nurse Practitioner - Family | R182450 (Maryland) | 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. Kelcy Wiley allows following entities to bill medicare on her behalf.
Entity Name | Privia Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140522000040 |
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Entity Name | Privia Care Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1164874426 PECOS PAC ID: 3274801139 Enrollment ID: O20170619000055 |
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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. Kelcy Wiley 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 |
Kelcy Wiley, NP-C 1 Anna Marsh Ln, Dummerston, VT 05301-3292 Ph: () - | Kelcy Wiley, NP-C 1 Anna Marsh Ln, Dummerston, VT 05301-3292 Ph: (410) 463-9418 |
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