Elise Middleton, is a medicare enrolled "Psychologist" provider in Richmond, California. Her current practice location is
4101 Macdonald Ave, Richmond, California. You can reach out to her office (for appointments etc.) via phone at
(510) 412-9200.
Elise Middleton is licensed to practice in * (Not Available) (license number ) 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 1619377611.
Healthcare Provider's Profile
| Full Name | Elise Middleton |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 4101 Macdonald Ave, Richmond, California |
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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: 1619377611
- Provider Enumeration Date: 08/26/2014
- Last Update Date: 08/18/2016
Medicare PECOS Information:
- PECOS PAC ID: 9133657703
- Enrollment ID: I20250109002742
Medical Identifiers
Medical identifiers for Elise Middleton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619377611 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YS0200X | Counselor - School | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | 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. Elise Middleton allows following entities to bill medicare on her behalf.
| Entity Name | Mark David Levine Md Professional Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154697944
PECOS PAC ID: 0143478305
Enrollment ID: O20120912000548 |
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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. Elise Middleton 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 |
|---|
Elise Middleton,
4101 Macdonald Ave,
Richmond, CA 94805-2333
Ph: (510) 412-9200 | Elise Middleton,
4101 Macdonald Ave,
Richmond, CA 94805-2333
Ph: (510) 412-9200 |
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