Mr Marc Dylan Gagnon, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Harwinton, Connecticut. His current practice location is
271 Locust Rd, Harwinton, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 233-8444.
Mr Marc Dylan Gagnon is licensed to practice in Connecticut (license number 12627) 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 1508631623.
Provider's Profile
Full Name | Mr Marc Dylan Gagnon |
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Gender | Male |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 271 Locust Rd, Harwinton, Connecticut |
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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: 1508631623
- Provider Enumeration Date: 11/20/2023
- Last Update Date: 11/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739532474
- Enrollment ID: I20240129003559
Medical Identifiers
Medical identifiers for Mr Marc Dylan Gagnon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508631623 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 12627 (Connecticut) | 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 Marc Dylan Gagnon allows following entities to bill medicare on his behalf.
Entity Name | The Center For Geriatric And Family Psychiatry, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1831134766 PECOS PAC ID: 8527059955 Enrollment ID: O20040524000236 |
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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. Mr Marc Dylan Gagnon 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 Marc Dylan Gagnon, PMHNP-BC 271 Locust Rd, Harwinton, CT 06791-2412 Ph: (203) 233-8444 | Mr Marc Dylan Gagnon, PMHNP-BC 271 Locust Rd, Harwinton, CT 06791-2412 Ph: (203) 233-8444 |
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