Kelly Marie Mulholland, NP - Medicare Nurse Practitioner in Phoenix, AZ

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Kelly Marie Mulholland, NP is a medicare enrolled "Nurse Practitioner" in Phoenix, Arizona. Her current practice location is 6036 N 19th Ave Ste 204, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (480) 616-0356.

Kelly Marie Mulholland is licensed to practice in Arizona (license number 301586) 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 1700640885.

Contact Information

Kelly Marie Mulholland, NP
6036 N 19th Ave Ste 204,
Phoenix, AZ 85015-2104
(480) 616-0356
(480) 616-0603

Map and Direction




Provider's Profile

Full NameKelly Marie Mulholland
GenderFemale
SpecialityNurse Practitioner
Location6036 N 19th Ave Ste 204, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1700640885
  • Provider Enumeration Date: 02/09/2024
  • Last Update Date: 06/13/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9931540879
  • Enrollment ID: I20240509002821

Medical Identifiers

Medical identifiers for Kelly Marie Mulholland such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1700640885NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 301586 (Arizona)Secondary
363L00000XNurse Practitioner 301586 (Arizona)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. Kelly Marie Mulholland allows following entities to bill medicare on her behalf.
Entity NameEmcare - Pnx Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902855992
PECOS PAC ID: 3779574165
Enrollment ID: O20040524000667
Entity NameLoop 101 Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376573378
PECOS PAC ID: 0840295481
Enrollment ID: O20061003000466
Entity Name303 Emergency Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518398585
PECOS PAC ID: 2567692528
Enrollment ID: O20140313001083

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. Kelly Marie Mulholland 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
Kelly Marie Mulholland, NP
P.o Box 29650, Dept # 880391,
Phoenix, AZ 85038-2690

Ph: (480) 626-1746		Kelly Marie Mulholland, NP
6036 N 19th Ave Ste 204,
Phoenix, AZ 85015-2104

Ph: (480) 616-0356

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.