Dr Timothy Brunelle, is a medicare enrolled "Clinical Neuropsychologist" provider in Boulder, Colorado. His current practice location is
255 Canyon Blvd Ste 200, Boulder, Colorado. You can reach out to his office (for appointments etc.) via phone at
(720) 744-0577.
Dr Timothy Brunelle is licensed to practice in Colorado (license number 5524) 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 1225488349.
Healthcare Provider's Profile
Full Name | Dr Timothy Brunelle |
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Gender | Male |
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Speciality | Clinical Neuropsychologist |
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Location | 255 Canyon Blvd Ste 200, Boulder, Colorado |
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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: 1225488349
- Provider Enumeration Date: 06/20/2016
- Last Update Date: 01/31/2022
Medicare PECOS Information:
- PECOS PAC ID: 2466992532
- Enrollment ID: I20241105001347
Medical Identifiers
Medical identifiers for Dr Timothy Brunelle such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225488349 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103G00000X | Clinical Neuropsychologist | 5524 (Colorado) | 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 Timothy Brunelle allows following entities to bill medicare on his behalf.
Entity Name | Neuroworks Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1184176067 PECOS PAC ID: 0244513547 Enrollment ID: O20170213000294 |
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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 Timothy Brunelle 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 Timothy Brunelle, 255 Canyon Blvd Ste 200, Boulder, CO 80302-4954 Ph: (720) 744-0577 | Dr Timothy Brunelle, 255 Canyon Blvd Ste 200, Boulder, CO 80302-4954 Ph: (720) 744-0577 |
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