Mr Kelly Jonathon Douck, CRNA in Wausau, WI - Medicare Certified Registered Nurse Anesthetist (crna)

Mr Kelly Jonathon Douck, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Wausau, Wisconsin. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Langlade Hospital - Hotel Dieu Of St Joseph Of Antigo Wisconsin and his current practice location is 333 Pine Ridge Blvd, Wausau, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (715) 845-5505.

Mr Kelly Jonathon Douck is licensed to practice in Wisconsin (license number 127347) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1447807086.

Contact Information

	Mr Kelly Jonathon Douck, CRNA
	333 Pine Ridge Blvd, Wausau, WI 54401-4102
	(715) 845-5505
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Kelly Jonathon Douck
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	5 Years
Location	333 Pine Ridge Blvd, Wausau, Wisconsin
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Kelly Jonathon Douck graduated from nursing school in 2019

NPI Data:

NPI Number: 1447807086
Provider Enumeration Date: 08/19/2019
Last Update Date: 09/20/2019

Medicare PECOS Information:

PECOS PAC ID: 6305177429
Enrollment ID: I20191003002525

Medical Identifiers

Medical identifiers for Mr Kelly Jonathon Douck such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447807086	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	127347 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Langlade Hospital	Antigo, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Langlade Hospital - Hotel Dieu Of St Joseph Of Antigo Wisconsin	1557271202	47

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. Mr Kelly Jonathon Douck allows following entities to bill medicare on his behalf.

Entity Name	Central Wisconsin Anesthesiology
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518999648 PECOS PAC ID: 5597667097 Enrollment ID: O20040124000074

Entity Name	Langlade Hospital - Hotel Dieu Of St Joseph Of Antigo Wisconsin
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831251040 PECOS PAC ID: 1557271202 Enrollment ID: O20040212000310

Entity Name	Central Wisconsin Anesthesiology
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518999648 PECOS PAC ID: 5597667097 Enrollment ID: O20040805000454

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. Mr Kelly Jonathon Douck 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
Mr Kelly Jonathon Douck, CRNA 3106 Sandgate Ct # 54476, Weston, WI 54476-5686 Ph: (920) 574-8003	Mr Kelly Jonathon Douck, CRNA 333 Pine Ridge Blvd, Wausau, WI 54401-4102 Ph: (715) 845-5505

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Wausau, WI

Elaine J. Olsen, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2727 Plaza Dr, Wausau, WI 54401 Phone: 715-847-3000
Laura B. Solverud, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 425 Pine Ridge Blvd, Ste 211, Wausau, WI 54401 Phone: 715-845-5505
Elliott Adent, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 425 Pine Ridge Blvd, Suite 211, Wausau, WI 54401 Phone: 715-845-5505
Steve Henkens, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 425 Pine Ridge Blvd, Suite 211, Wausau, WI 54401 Phone: 715-845-5505 Fax: 715-848-2884
Aaron Zondlo, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 425 Pine Ridge Blvd Ste 211, Wausau, WI 54401 Phone: 715-845-5505 Fax: 715-848-2884
Marissa J Hernandez, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 411 Westwood Dr, Wausau, WI 54401 Phone: 715-847-2558 Fax: 715-847-2557
Michael J Hein, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 411 Westwood Dr, Wausau, WI 54401 Phone: 715-847-2558 Fax: 715-847-2752

Mr Kelly Jonathon Douck, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Wausau, WI