Kelsey Fobbe, RN is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Saint Johns, Michigan. Her current practice location is
2063 Secretariat Ln, Saint Johns, Michigan. You can reach out to her office (for appointments etc.) via phone at
(517) 282-1295.
Kelsey Fobbe is licensed to practice in Michigan (license number 4704278919) 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 1619548740.
Provider's Profile
Full Name | Kelsey Fobbe |
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Gender | Female |
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Speciality | Nurse Anesthetist, Certified Registered |
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Location | 2063 Secretariat Ln, Saint Johns, Michigan |
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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: 1619548740
- Provider Enumeration Date: 07/09/2021
- Last Update Date: 09/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 3476938630
- Enrollment ID: I20220923002389
Medical Identifiers
Medical identifiers for Kelsey Fobbe such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619548740 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 4704278919 (Michigan) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 4704278919 (Michigan) | 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. Kelsey Fobbe allows following entities to bill medicare on her behalf.
Entity Name | Edward W Sparrow Hospital Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366498107 PECOS PAC ID: 6709799166 Enrollment ID: O20040311001138 |
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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. Kelsey Fobbe 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 |
Kelsey Fobbe, RN 2063 Secretariat Ln, Saint Johns, MI 48879-8034 Ph: (517) 282-1295 | Kelsey Fobbe, RN 2063 Secretariat Ln, Saint Johns, MI 48879-8034 Ph: (517) 282-1295 |
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