Mary K Kiesewetter, PMHNP - Medicare Nurse Practitioner in Champaign, IL

Mary K Kiesewetter, PMHNP is a medicare enrolled "Nurse Practitioner" in Champaign, Illinois. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Carle Health Care Incorporated and her current practice location is 1802 S Mattis Ave, Champaign, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 365-2855.

Mary K Kiesewetter is licensed to practice in Illinois (license number 209020494) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114563640.

Contact Information

Mary K Kiesewetter, PMHNP
1802 S Mattis Ave,
Champaign, IL 61821-5923
(217) 365-2855
Not Available



Provider's Profile

Full NameMary K Kiesewetter
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location1802 S Mattis Ave, Champaign, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mary K Kiesewetter graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1114563640
  • Provider Enumeration Date: 11/19/2019
  • Last Update Date: 11/21/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 7214362425
  • Enrollment ID: I20200116001310

Medical Identifiers

Medical identifiers for Mary K Kiesewetter such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114563640NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 209020494 (Illinois)Primary
363LP0808XNurse Practitioner - Psychiatric/mental Health 209.020494 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
The Carle Foundation HospitalUrbana, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Carle Health Care Incorporated3577515774808

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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. Mary K Kiesewetter allows following entities to bill medicare on her behalf.
Entity NameCarle Health Care Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154653947
PECOS PAC ID: 3577515774
Enrollment ID: O20100513000829

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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. Mary K Kiesewetter 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 AddressPractice Location Address
Mary K Kiesewetter, PMHNP
1802 S Mattis Ave,
Champaign, IL 61821-5923

Ph: (217) 365-2855
Mary K Kiesewetter, PMHNP
1802 S Mattis Ave,
Champaign, IL 61821-5923

Ph: (217) 365-2855

News Archive

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Cancer immunotherapy could treat HIV

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Nurse Practitioner Nurses in Champaign, IL

Emily Stephenson, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1701 Curtis Rd, Champaign, IL 61822
Phone: 217-365-6207    Fax: 217-365-6380
Mrs. Tiffany Ann Rushing, APN, FNP-BC, PMHNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1802 S Mattis Ave, Champaign, IL 61821
Phone: 217-365-2855    Fax: 217-365-2856
Maddison P. Draper, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2718 N Prospect Ave, Champaign, IL 61822
Phone: 217-337-3852    Fax: 217-337-3853
Jessica Lynn Mandrell,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 819 Bloomington Rd, Champaign, IL 61820
Phone: 217-356-1558    
Ms. Greta Obereiner, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1801 Windsor Rd, Champaign, IL 61822
Phone: 217-366-8130    Fax: 217-366-6106
Alger Penas, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2300 S 1st St, Champaign, IL 61820
Phone: 217-383-9400    Fax: 217-383-9691
Miss Abigayl Frields, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1813 W Kirby Ave Ste 120, Champaign, IL 61821
Phone: 217-383-3131    

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