Mr Matthew Michael Carbonelli, PHD is a medicare enrolled "Psychologist - Clinical" provider in Milwaukee, Wisconsin. His current practice location is
2311 N Prospect Ave, Milwaukee, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 390-3000.
Mr Matthew Michael Carbonelli is licensed to practice in Wisconsin (license number 4158) 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 1396259818.
Healthcare Provider's Profile
Full Name | Mr Matthew Michael Carbonelli |
---|
Gender | Male |
---|
Speciality | Psychologist - Clinical |
---|
Location | 2311 N Prospect Ave, Milwaukee, Wisconsin |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1396259818
- Provider Enumeration Date: 11/20/2017
- Last Update Date: 09/04/2023
Medicare PECOS Information:
- PECOS PAC ID: 0547635237
- Enrollment ID: I20230929000927
Medical Identifiers
Medical identifiers for Mr Matthew Michael Carbonelli such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1396259818 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | 4158 (Wisconsin) | 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 Matthew Michael Carbonelli allows following entities to bill medicare on his behalf.
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
---|
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 Matthew Michael Carbonelli 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 Matthew Michael Carbonelli, PHD 2311 N Prospect Ave, Milwaukee, WI 53211-4445 Ph: (715) 390-3000 | Mr Matthew Michael Carbonelli, PHD 2311 N Prospect Ave, Milwaukee, WI 53211-4445 Ph: (715) 390-3000 |
Reviews and Comments