Kelly Marie Scott, PMHNP in San Diego, CA - Medicare Nurse Practitioner

Kelly Marie Scott, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in San Diego, California. Her current practice location is 2630 1st Ave, San Diego, California. You can reach out to her office (for appointments etc.) via phone at (619) 795-8746.

Kelly Marie Scott is licensed to practice in California (license number 95015026) 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 1013420801.

Contact Information

	Kelly Marie Scott, PMHNP
	2630 1st Ave, San Diego, CA 92103-6599
	(619) 795-8746
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelly Marie Scott
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	2630 1st Ave, San Diego, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013420801
Provider Enumeration Date: 11/15/2017
Last Update Date: 07/30/2024

Medicare PECOS Information:

PECOS PAC ID: 0446518211
Enrollment ID: I20190111002004

Medical Identifiers

Medical identifiers for Kelly Marie Scott such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013420801	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	0216030 (Ohio)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95015026 (California)	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 Scott allows following entities to bill medicare on her behalf.

Entity Name	Signature Health, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679767289 PECOS PAC ID: 8628970985 Enrollment ID: O20040126000762

Entity Name	Magnolia Clubhouse Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902139033 PECOS PAC ID: 8022291947 Enrollment ID: O20110330000222

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 Scott 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
Kelly Marie Scott, PMHNP 2630 1st Ave, San Diego, CA 92103-6599 Ph: (619) 234-2158	Kelly Marie Scott, PMHNP 2630 1st Ave, San Diego, CA 92103-6599 Ph: (619) 795-8746

Reviews and Comments

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Kelly Marie Scott, PMHNP - Medicare Nurse Practitioner in San Diego, CA