Mr Mitchell Tyler Bacon, in Portland, OR - Medicare Marriage & Family Therapist Provider

Mr Mitchell Tyler Bacon, is a medicare enrolled "Marriage & Family Therapist" provider in Portland, Oregon. His current practice location is 3550 N Interstate Ave, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (800) 813-2000.

Mr Mitchell Tyler Bacon is licensed to practice in Oregon (license number T1282) 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 1083967442.

Contact Information

	Mr Mitchell Tyler Bacon,
	3550 N Interstate Ave, Portland, OR 97227-1196
	(800) 813-2000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Mitchell Tyler Bacon
Gender	Male
Speciality	Marriage & Family Therapist
Location	3550 N Interstate Ave, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083967442
Provider Enumeration Date: 10/23/2012
Last Update Date: 12/21/2021

Medicare PECOS Information:

PECOS PAC ID: 5698126589
Enrollment ID: I20240104002305

Medical Identifiers

Medical identifiers for Mr Mitchell Tyler Bacon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083967442	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	LF60724149 (Washington)	Secondary
106H00000X	Marriage & Family Therapist	T1282 (Oregon)	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 Mitchell Tyler Bacon allows following entities to bill medicare on his behalf.

Entity Name	Kaiser Foundation Health Plan Of The Northwest
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040220000099

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 Mitchell Tyler Bacon 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 Mitchell Tyler Bacon, 7454 N Monteith Ave, Portland, OR 97203-4265 Ph: (603) 667-3282	Mr Mitchell Tyler Bacon, 3550 N Interstate Ave, Portland, OR 97227-1196 Ph: (800) 813-2000

Reviews and Comments

Marriage & Family Therapist in Portland, OR

Karissa Lynn Catalano, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2415 Se 43rd Ave, Portland, OR 97206 Phone: 503-238-0705
Jennifer D Samsom, MA Couples Therapy Medicare: Medicare Enrolled Practice Location: 2245 Sw Troy St, Portland, OR 97219 Phone: 503-341-6393
Therese Long, Couples Therapy Medicare: Medicare Enrolled Practice Location: 4300 Ne Fremont St Ste 260, Portland, OR 97213 Phone: 503-544-9996
Kathia Rabelo, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 820 Nw 21st Ave Ste B, Portland, OR 97209 Phone: 626-318-9783
Polly Elizabeth Harrison, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 13601 Se Lincoln Ct, Portland, OR 97233 Phone: 503-558-5339
Mrs. Lindsey Erin Gibson, MED Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1110 Se Alder St Ste 301, Portland, OR 97214 Phone: 971-400-5407
Danielle Ellen Lieb-foley, MA, MFT, ATR Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1020 Sw Taylor St, Suite 345, Portland, OR 97205 Phone: 503-704-6101

Mr Mitchell Tyler Bacon, - Medicare Couples Therapy in Portland, OR