Dr Jessica Elizabeth-rose Carroll, PHD is a medicare enrolled "Psychologist - Clinical" provider in Mountain View, Hawaii. Her current practice location is
11-3059 Plumeria Street, Mountain View, Hawaii. You can reach out to her office (for appointments etc.) via phone at
(808) 255-4247.
Dr Jessica Elizabeth-rose Carroll is licensed to practice in Hawaii (license number PSY-1813) 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 1306222401.
Healthcare Provider's Profile
| Full Name | Dr Jessica Elizabeth-rose Carroll |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 11-3059 Plumeria Street, Mountain View, Hawaii |
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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: 1306222401
- Provider Enumeration Date: 07/31/2015
- Last Update Date: 12/12/2019
Medicare PECOS Information:
- PECOS PAC ID: 3870921547
- Enrollment ID: I20200311000539
Medical Identifiers
Medical identifiers for Dr Jessica Elizabeth-rose Carroll such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306222401 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY-1813 (Hawaii) | 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 Jessica Elizabeth-rose Carroll allows following entities to bill medicare on her behalf.
| Entity Name | Ka Hoku Kai Counseling Center, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043859200
PECOS PAC ID: 2961830633
Enrollment ID: O20200311000426 |
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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 Jessica Elizabeth-rose Carroll 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 |
|---|
Dr Jessica Elizabeth-rose Carroll, PHD
Po Box 711570,
Mountain View, HI 96771-1570
Ph: (808) 255-4247 | Dr Jessica Elizabeth-rose Carroll, PHD
11-3059 Plumeria Street,
Mountain View, HI 96771-1570
Ph: (808) 255-4247 |
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