Dr Lisa Marie Kedzuf-mcginnis, OD is a medicare enrolled "Optometrist" provider in Cleveland, Oklahoma. Her current practice location is
107 S Broadway St, Cleveland, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 358-2245.
Dr Lisa Marie Kedzuf-mcginnis is licensed to practice in Oklahoma (license number 2477) 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 1134216609.
Healthcare Provider's Profile
| Full Name | Dr Lisa Marie Kedzuf-mcginnis |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 107 S Broadway St, Cleveland, Oklahoma |
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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: 1134216609
- Provider Enumeration Date: 10/06/2006
- Last Update Date: 07/06/2022
Medicare PECOS Information:
- PECOS PAC ID: 1951318872
- Enrollment ID: I20060329000012
Medical Identifiers
Medical identifiers for Dr Lisa Marie Kedzuf-mcginnis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134216609 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 2477 (Oklahoma) | 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. Dr Lisa Marie Kedzuf-mcginnis allows following entities to bill medicare on her behalf.
| Provider Name | Kedzymac Enterprises Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1376272369
PECOS PAC ID: 5890175798
Enrollment ID: O20220709000675 |
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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. Dr Lisa Marie Kedzuf-mcginnis 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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Dr Lisa Marie Kedzuf-mcginnis, OD
9318 Scarlet Oak Dr,
Sand Springs, OK 74063-3901
Ph: (918) 520-4344 | Dr Lisa Marie Kedzuf-mcginnis, OD
107 S Broadway St,
Cleveland, OK 74020-4614
Ph: (918) 358-2245 |
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