KCC Infusion, LLC

PAC ID

4688076896The PECOS associate control ID: one enrolled organization, which may hold several NPIs

Provider type

Part B Supplier - Clinic/Group Practice

Enrolled in

LA, MS

Enrollments

2

Group size

2 cliniciansAs Care Compare reports it

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice locations

2In 2 places

Enrollment records 2

These NPI records belong to the same enrolled organization. Each has its own page.

• KCC Infusion, LLC

  dba Shreveport Infusion Center

  • Infusion Therapy Clinic/Center
  • Shreveport, LA
  • NPI 1225794506
• KCC Infusion, LLC

  dba Vicksburg Infusion Center

  • Infusion Therapy Clinic/Center
  • Vicksburg, MS
  • NPI 1942875158

Clinicians who reassign their Medicare benefits to this group (3) or whom Care Compare lists as members (2).

• Olatunji Jonathan Oluwatade, MD

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1477677458
• Shelly Hodaya Twito, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1619624079
• Jenna Van, MSN

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1497200257

• Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
• Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
• NPPES NPI Registry: the names and addresses of the NPIs above.