Kim Dielmann, PHD is a medicare enrolled "Psychologist - Clinical" provider in Conway, Arkansas. She graduated from healthcare school in 2005 and has 19 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is
4206 Prince St, Conway, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(501) 932-2055.
Kim Dielmann is licensed to practice in Arkansas (license number 07-27P) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1538371190.
Healthcare Provider's Profile
| Full Name | Kim Dielmann |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 19 Years |
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| Location | 4206 Prince St, Conway, Arkansas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kim Dielmann graduated from medical school in 2005
NPI Data:
- NPI Number: 1538371190
- Provider Enumeration Date: 05/04/2007
- Last Update Date: 06/10/2019
Medicare PECOS Information:
- PECOS PAC ID: 0244496230
- Enrollment ID: I20190930000251
Medical Identifiers
Medical identifiers for Kim Dielmann such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538371190 | NPI | - | NPPES |
| 194027719 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 07-27P (Arkansas) | Secondary |
| 103T00000X | Psychologist | 07-27P (Arkansas) | Secondary |
| 103TC0700X | Psychologist - Clinical | 07-27P (Arkansas) | 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. Kim Dielmann allows following entities to bill medicare on her behalf.
| Entity Name | Conway Psychological Assessment Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255697330
PECOS PAC ID: 5991961989
Enrollment ID: O20120718000888 |
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| Entity Name | Conway Behavioral Health, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245728484
PECOS PAC ID: 3779857891
Enrollment ID: O20181010003468 |
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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. Kim Dielmann 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 |
|---|
Kim Dielmann, PHD
4206 Prince St,
Conway, AR 72034-9398
Ph: (501) 932-2055 | Kim Dielmann, PHD
4206 Prince St,
Conway, AR 72034-9398
Ph: (501) 932-2055 |
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