Kelly A Gardner, DPT is a medicare enrolled "Physical Therapist" provider in Clayton, New York. Her current practice location is
307 Riverside Dr, Clayton, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 285-5159.
Kelly A Gardner is licensed to practice in New York (license number 014782) 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 1184620478.
Healthcare Provider's Profile
| Full Name | Kelly A Gardner |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 307 Riverside Dr, Clayton, New York |
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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: 1184620478
- Provider Enumeration Date: 06/22/2005
- Last Update Date: 12/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 0749520443
- Enrollment ID: I20190315000985
Medical Identifiers
Medical identifiers for Kelly A Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184620478 | NPI | - | NPPES |
| 02302812 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 014782 (New York) | 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. Kelly A Gardner allows following entities to bill medicare on her behalf.
| Provider Name | South Jefferson Physical Therapy Pc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1407930829
PECOS PAC ID: 8224205604
Enrollment ID: O20120126000029 |
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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. Kelly A Gardner 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 |
|---|
Kelly A Gardner, DPT
70 N Main St,
Adams, NY 13605-3102
Ph: (315) 232-2225 | Kelly A Gardner, DPT
307 Riverside Dr,
Clayton, NY 13624-1022
Ph: (315) 285-5159 |
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