Mr Clarence Leonard Bonander Jr, is a medicare enrolled "Psychologist - Clinical" provider in Cambridge, Minnesota. His current practice location is
817 Main St N, Cambridge, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(763) 325-0300.
Mr Clarence Leonard Bonander Jr is licensed to practice in Minnesota (license number GL0087) 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 1881149433.
Healthcare Provider's Profile
Full Name | Mr Clarence Leonard Bonander Jr |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 817 Main St N, Cambridge, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1881149433
- Provider Enumeration Date: 08/23/2016
- Last Update Date: 04/09/2019
Medicare PECOS Information:
- PECOS PAC ID: 2264765262
- Enrollment ID: I20190606000682
Medical Identifiers
Medical identifiers for Mr Clarence Leonard Bonander Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881149433 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | GL0087 (Minnesota) | 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. Mr Clarence Leonard Bonander Jr allows following entities to bill medicare on his behalf.
Entity Name | Nystrom & Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592 |
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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. Mr Clarence Leonard Bonander Jr 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 |
Mr Clarence Leonard Bonander Jr, 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 Ph: (651) 379-1704 | Mr Clarence Leonard Bonander Jr, 817 Main St N, Cambridge, MN 55008-1275 Ph: (763) 325-0300 |
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