Dr Kenneth Erwin Richardson, MD, PHD in Provo, UT - Medicare Pediatrics

Dr Kenneth Erwin Richardson, MD, PHD is a medicare enrolled "Pediatrics - Neonatal-perinatal Medicine" physician in Provo, Utah. His current practice location is 1034 N 500 W, Neonatology, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 357-7707.

Dr Kenneth Erwin Richardson is licensed to practice in Utah (license number 295555-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1265571269.

Contact Information

	Dr Kenneth Erwin Richardson, MD, PHD
	1034 N 500 W, Neonatology, Provo, UT 84604-3380
	(801) 357-7707
	(801) 370-9061

Physician's Profile

Full Name	Dr Kenneth Erwin Richardson
Gender	Male
Speciality	Pediatrics - Neonatal-perinatal Medicine
Location	1034 N 500 W, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265571269
Provider Enumeration Date: 02/06/2007
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 9739407164
Enrollment ID: I20150416000064

Medical Identifiers

Medical identifiers for Dr Kenneth Erwin Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265571269	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080N0001X	Pediatrics - Neonatal-perinatal Medicine	295555-1205 (Utah)	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. Dr Kenneth Erwin Richardson 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
Dr Kenneth Erwin Richardson, MD, PHD 1034 N 500 W, Neonatology, Provo, UT 84604-3380 Ph: (801) 357-7707	Dr Kenneth Erwin Richardson, MD, PHD 1034 N 500 W, Neonatology, Provo, UT 84604-3380 Ph: (801) 357-7707

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Pediatrics Doctors in Provo, UT

Dr. Renae Holland, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1300 E Center St, Utah State Hospital, Provo, UT 84606 Phone: 801-344-4311 Fax: 801-344-4225
Dr. Joshua Darrell Fuller, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1675 N Freedom Blvd Ste 3, Provo, UT 84604 Phone: 801-377-8000
Jordan Gaudio, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-1700
Danielle Elise Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-8411
Dr. Chuanchau Jerry Jou, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 311, Provo, UT 84604 Phone: 385-477-6800 Fax: 385-477-6801
Leslie Mark Lang, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7707
Bradley Wayne Anderson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1355 N University Ave, #210, Provo, UT 84604 Phone: 801-373-8930 Fax: 801-377-6811

Dr Kenneth Erwin Richardson, MD, PHD - Medicare Pediatrics in Provo, UT