Kelly C Fagundes, PT is a medicare enrolled "Physical Therapist" provider in Fish Creek, Wisconsin. Her current practice location is
8499 St Hwy 42, Fish Creek, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 421-4600.
Kelly C Fagundes is licensed to practice in Wisconsin (license number ) 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 1144337536.
Healthcare Provider's Profile
Full Name | Kelly C Fagundes |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 8499 St Hwy 42, Fish Creek, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1144337536
- Provider Enumeration Date: 08/23/2006
- Last Update Date: 02/01/2018
Medicare PECOS Information:
- PECOS PAC ID: 2264792704
- Enrollment ID: I20180201001889
Medical Identifiers
Medical identifiers for Kelly C Fagundes such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144337536 | NPI | - | NPPES |
36107100 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | (Wisconsin) | Primary |
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 C Fagundes 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 C Fagundes, PT 3250 Wooded Ln, Baileys Harbor, WI 54202-9012 Ph: (920) 421-4600 | Kelly C Fagundes, PT 8499 St Hwy 42, Fish Creek, WI 54212-9419 Ph: (920) 421-4600 |
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