Matthew Kam, is a medicare enrolled "Marriage & Family Therapist" provider in Chubbuck, Idaho. His current practice location is
4650 Hawthorne Rd Ste 3b, Chubbuck, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 252-5621.
Matthew Kam is licensed to practice in Idaho (license number LPC5260) 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 1457646895.
Healthcare Provider's Profile
| Full Name | Matthew Kam |
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| Gender | Male |
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| Speciality | Marriage & Family Therapist |
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| Location | 4650 Hawthorne Rd Ste 3b, Chubbuck, Idaho |
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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: 1457646895
- Provider Enumeration Date: 06/14/2011
- Last Update Date: 04/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 6406178268
- Enrollment ID: I20240112001244
Medical Identifiers
Medical identifiers for Matthew Kam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1457646895 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | LPC5260 (Idaho) | 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. Matthew Kam allows following entities to bill medicare on his behalf.
| Entity Name | Canvi Behavioral Health Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1144984873
PECOS PAC ID: 0941692073
Enrollment ID: O20220121000627 |
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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. Matthew Kam 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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Matthew Kam,
4650 Hawthorne Rd Ste 3b,
Chubbuck, ID 83202-2376
Ph: (208) 252-5621 | Matthew Kam,
4650 Hawthorne Rd Ste 3b,
Chubbuck, ID 83202-2376
Ph: (208) 252-5621 |
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