Alexander Lodge, MA is a medicare enrolled "Psychologist" provider in Williston, Vermont. His current practice location is
75 Talcott Rd Ste 30, Williston, Vermont. You can reach out to his office (for appointments etc.) via phone at
(802) 503-2929.
Alexander Lodge is licensed to practice in Vermont (license number 047.0133699) 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 1720700404.
Healthcare Provider's Profile
Full Name | Alexander Lodge |
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Gender | Male |
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Speciality | Psychologist |
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Location | 75 Talcott Rd Ste 30, Williston, Vermont |
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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: 1720700404
- Provider Enumeration Date: 09/19/2022
- Last Update Date: 01/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 3173066636
- Enrollment ID: I20240625002468
Medical Identifiers
Medical identifiers for Alexander Lodge such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720700404 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 047.0133699 (Vermont) | Secondary |
103T00000X | Psychologist | 047.0133699 (Vermont) | Primary |
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. Alexander Lodge allows following entities to bill medicare on his behalf.
Entity Name | Xander Lodge, Ma, Plc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1255053930 PECOS PAC ID: 2264975721 Enrollment ID: O20240625002195 |
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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. Alexander Lodge 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 |
Alexander Lodge, MA 629 Metcalf Dr, Williston, VT 05495-8802 Ph: (802) 503-2929 | Alexander Lodge, MA 75 Talcott Rd Ste 30, Williston, VT 05495-8122 Ph: (802) 503-2929 |
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