Nicolas Gudino Jr, in Bloomington, IL - Medicare Counselor Provider

Nicolas Gudino Jr, is a medicare enrolled "Counselor - Mental Health" provider in Bloomington, Illinois. His current practice location is 108 W Market St, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 827-5351.

Nicolas Gudino Jr is licensed to practice in Illinois (license number 180010615) 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 1063833457.

Contact Information

	Nicolas Gudino Jr,
	108 W Market St, Bloomington, IL 61701-3918
	(309) 827-5351
	(309) 829-6808

Map and Direction

Healthcare Provider's Profile

Full Name	Nicolas Gudino Jr
Gender	Male
Speciality	Counselor - Mental Health
Location	108 W Market St, Bloomington, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063833457
Provider Enumeration Date: 01/02/2014
Last Update Date: 05/26/2022

Medicare PECOS Information:

PECOS PAC ID: 8921440504
Enrollment ID: I20240528003482

Medical Identifiers

Medical identifiers for Nicolas Gudino Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063833457	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	180010615 (Illinois)	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. Nicolas Gudino Jr allows following entities to bill medicare on his behalf.

Entity Name	Edgewood Clinical Services P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295914646 PECOS PAC ID: 3971963901 Enrollment ID: O20230721001228

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. Nicolas Gudino 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
Nicolas Gudino Jr, 108 W Market St, Bloomington, IL 61701-3918 Ph: (309) 827-5351	Nicolas Gudino Jr, 108 W Market St, Bloomington, IL 61701-3918 Ph: (309) 827-5351

Reviews and Comments

Counselor in Bloomington, IL

Mr. Bryan James Hinman, M.A. Counselor Medicare: Medicare Enrolled Practice Location: 702 W Chestnut St, Bloomington, IL 61701 Phone: 309-557-1409
William Douglas Portis, LCPC CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 808 S Eldorado Rd Ste 100c, Bloomington, IL 61704 Phone: 309-889-6222
Victoria Fetter, Counselor Medicare: Medicare Enrolled Practice Location: 808 S Eldorado Rd Ste 102, Bloomington, IL 61704 Phone: 888-428-7890 Fax: 877-428-7891
Timothy Robert Wright, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 W Market St, Bloomington, IL 61701 Phone: 309-827-5351
Mr. Joshua Beckwith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 W Market St, Bloomington, IL 61701 Phone: 309-827-5351 Fax: 309-829-6808
Mrs. Lisa Diane Neuweg, MA, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 702 W Chestnut St, Bloomington, IL 61701 Phone: 309-827-6026
Mr. Harold Frank Piccinelli, M.S., L.C.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1003 Martin Luther King Dr, Bloomington, IL 61701 Phone: 309-827-6026

Nicolas Gudino Jr, - Medicare Counselor in Bloomington, IL