Dr Charles Cutez Waller, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Fairfax, Virginia. His current practice location is
8221 Willow Oaks Corporate Dr Ste 4-425, Fairfax, Virginia. You can reach out to his office (for appointments etc.) via phone at
(703) 289-7560.
Dr Charles Cutez Waller is licensed to practice in Virginia (license number 0810008049) 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 1659866556.
Healthcare Provider's Profile
| Full Name | Dr Charles Cutez Waller |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 8221 Willow Oaks Corporate Dr Ste 4-425, Fairfax, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1659866556
- Provider Enumeration Date: 06/25/2018
- Last Update Date: 08/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 8224483417
- Enrollment ID: I20231007000824
Medical Identifiers
Medical identifiers for Dr Charles Cutez Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659866556 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 0810008049 (Virginia) | 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. Dr Charles Cutez Waller allows following entities to bill medicare on his behalf.
| Entity Name | Inova Health Care Services |
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| Entity Type | Part B Supplier - Hospital Department(s) |
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| Entity Identifiers | NPI Number: 1952320061
PECOS PAC ID: 2466351093
Enrollment ID: O20110104000935 |
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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. Dr Charles Cutez Waller 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 |
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Dr Charles Cutez Waller, PSYD
5605 Cypress Creek Dr Apt 203,
Chillum, MD 20782-3511
Ph: (504) 402-3601 | Dr Charles Cutez Waller, PSYD
8221 Willow Oaks Corporate Dr Ste 4-425,
Fairfax, VA 22031-4512
Ph: (703) 289-7560 |
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