Kyle Allen Wickliff, is a medicare enrolled "Anesthesiologist Assistant" in Richmond, Virginia. His current practice location is
3850 W Weyburn Rd, Richmond, Virginia. You can reach out to his office (for appointments etc.) via phone at
(540) 729-7407.
Kyle Allen Wickliff is licensed to practice in Virginia (license number 0024186283) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659028090.
Provider's Profile
| Full Name | Kyle Allen Wickliff |
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| Gender | Male |
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| Speciality | Anesthesiologist Assistant |
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| Location | 3850 W Weyburn Rd, Richmond, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1659028090
- Provider Enumeration Date: 03/06/2022
- Last Update Date: 09/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 3678948940
- Enrollment ID: I20230419001104
Medical Identifiers
Medical identifiers for Kyle Allen Wickliff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659028090 | NPI | - | NPPES |
| 0001263425 | Other | VA | RN LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WC0200X | Registered Nurse - Critical Care Medicine | 0001263425 (Virginia) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 0024186283 (Virginia) | 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. Kyle Allen Wickliff allows following entities to bill medicare on his behalf.
| Entity Name | American Anesthesiology Of Virginia Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417994872
PECOS PAC ID: 6800790023
Enrollment ID: O20080812000606 |
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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. Kyle Allen Wickliff 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 |
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Kyle Allen Wickliff,
3850 W Weyburn Rd,
Richmond, VA 23235-2044
Ph: (540) 729-7407 | Kyle Allen Wickliff,
3850 W Weyburn Rd,
Richmond, VA 23235-2044
Ph: (540) 729-7407 |
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