Clay Justin Crockett, PMHNP-BC in Buckeye, AZ

Clay Justin Crockett, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Buckeye, Arizona. His current practice location is 1820 N 202nd Ave, Buckeye, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 820-3201.

Clay Justin Crockett is licensed to practice in Arizona (license number 294847) 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 1164120150.

Contact Information

	Clay Justin Crockett, PMHNP-BC
	1820 N 202nd Ave, Buckeye, AZ 85396-8712
	(602) 820-3201
	Not Available

Map and Direction

Provider's Profile

Full Name	Clay Justin Crockett
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1820 N 202nd Ave, Buckeye, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164120150
Provider Enumeration Date: 02/20/2023
Last Update Date: 10/06/2023

Medicare PECOS Information:

PECOS PAC ID: 8527420116
Enrollment ID: I20230814003231

Medical Identifiers

Medical identifiers for Clay Justin Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164120150	NPI	-	NPPES
138626	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WP0808X	Registered Nurse - Psychiatric/mental Health	RN197246 (Arizona)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	294847 (Arizona)	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. Clay Justin Crockett allows following entities to bill medicare on his behalf.

Entity Name	Neighborhood Outreach Access To Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942518550 PECOS PAC ID: 3577743764 Enrollment ID: O20110204000504

Entity Name	Dr Gregory Carr Md Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386041861 PECOS PAC ID: 3072828607 Enrollment ID: O20150812006188

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. Clay Justin Crockett 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
Clay Justin Crockett, PMHNP-BC 1820 N 202nd Ave, Buckeye, AZ 85396-8712 Ph: (602) 820-3201	Clay Justin Crockett, PMHNP-BC 1820 N 202nd Ave, Buckeye, AZ 85396-8712 Ph: (602) 820-3201

Reviews and Comments

Nurse Practitioner Nurses in Buckeye, AZ

Carmela Marfori Fernandez, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 525 S Watson Rd Ste 200, Buckeye, AZ 85326 Phone: 623-385-7900
Ruth Bailey, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 23839 W Chipman Rd, Buckeye, AZ 85326 Phone: 602-565-8806
Allison Stuart, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20460 W Legend Trl, Buckeye, AZ 85396 Phone: 928-504-4700
Dr. Susan Thompson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 26700 S Us Highway 85, Buckeye, AZ 85326 Phone: 623-386-6160
Yvette Ako Lindley, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1300 S Watson Rd # A114-506, Buckeye, AZ 85326 Phone: 470-554-6191
Maria Lourdes Arndt, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 26721 W Mohawk Ln, Buckeye, AZ 85396 Phone: 928-533-9698
Mrs. Sara Brandal, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 21029 W Main St Ste 102, Buckeye, AZ 85396 Phone: 623-248-6404 Fax: 623-213-8541

Clay Justin Crockett, PMHNP-BC - Medicare Nurse Practitioner in Buckeye, AZ