Ms Kelly M Bistline, APRN is a medicare enrolled "Nurse Practitioner - Family" in Bonneau, South Carolina. Her current practice location is
1401 Main St, Bonneau, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 825-3404.
Ms Kelly M Bistline is licensed to practice in South Carolina (license number 26733) 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 1144947391.
Provider's Profile
| Full Name | Ms Kelly M Bistline |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1401 Main St, Bonneau, South Carolina |
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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: 1144947391
- Provider Enumeration Date: 10/27/2022
- Last Update Date: 10/27/2022
Medicare PECOS Information:
- PECOS PAC ID: 4082082276
- Enrollment ID: I20221118001714
Medical Identifiers
Medical identifiers for Ms Kelly M Bistline such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144947391 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 26733 (South Carolina) | 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. Ms Kelly M Bistline allows following entities to bill medicare on her behalf.
| Entity Name | Palmetto Primary Care Physicians Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073234928
PECOS PAC ID: 4880508068
Enrollment ID: O20031113000287 |
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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. Ms Kelly M Bistline 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 |
|---|
Ms Kelly M Bistline, APRN
1401 Main St,
Bonneau, SC 29431-5013
Ph: (843) 825-3404 | Ms Kelly M Bistline, APRN
1401 Main St,
Bonneau, SC 29431-5013
Ph: (843) 825-3404 |
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