Mrs Kelly Mitzen, PA-C in Washington, DC - Medicare Physician Assistant

Mrs Kelly Mitzen, PA-C is a medicare enrolled "Physician Assistant - Medical" in Washington, District Of Columbia. Her current practice location is Dilorenzo Tricare Health Clinic, Army Pentagon 5801, Washington, District Of Columbia. You can reach out to her office (for appointments etc.) via phone at (703) 692-8950.

Mrs Kelly Mitzen is licensed to practice in Virginia (license number 0110002992) 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 1073584777.

Contact Information

	Mrs Kelly Mitzen, PA-C
	Dilorenzo Tricare Health Clinic, Army Pentagon 5801, Washington, DC 20310-2802
	(703) 692-8950
	Not Available

Provider's Profile

Full Name	Mrs Kelly Mitzen
Gender	Female
Speciality	Physician Assistant - Medical
Location	Dilorenzo Tricare Health Clinic, Washington, District Of Columbia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073584777
Provider Enumeration Date: 01/30/2006
Last Update Date: 03/20/2014

Medicare PECOS Information:

PECOS PAC ID: 1557509114
Enrollment ID: I20130521000689

Medical Identifiers

Medical identifiers for Mrs Kelly Mitzen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073584777	NPI	-	NPPES
1073584777	Other		NPI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	0110002992 (Virginia)	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. Mrs Kelly Mitzen 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
Mrs Kelly Mitzen, PA-C Dilorenzo Tricare Health Clinic, Army Pentagon 5801, Washington, DC 20310-2802 Ph: (703) 692-8950	Mrs Kelly Mitzen, PA-C Dilorenzo Tricare Health Clinic, Army Pentagon 5801, Washington, DC 20310-2802 Ph: (703) 692-8950

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Mrs Kelly Mitzen, PA-C - Medicare Physician Assistant in Washington, DC