Mr Mark Andre Dupont, MA LP LADC is a medicare enrolled "Psychologist" provider in Thief River Falls, Minnesota. His current practice location is
3001 Sanford Pkwy, Thief River Falls, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 681-4747.
Mr Mark Andre Dupont is licensed to practice in Minnesota (license number LP1455) 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 1003932518.
Healthcare Provider's Profile
Full Name | Mr Mark Andre Dupont |
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Gender | Male |
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Speciality | Psychologist |
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Location | 3001 Sanford Pkwy, Thief River Falls, Minnesota |
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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: 1003932518
- Provider Enumeration Date: 03/22/2007
- Last Update Date: 05/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 5991072563
- Enrollment ID: I20170602000286
Medical Identifiers
Medical identifiers for Mr Mark Andre Dupont such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1003932518 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 301178 (Minnesota) | Secondary |
103T00000X | Psychologist | LP1455 (Minnesota) | 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 Mark Andre Dupont allows following entities to bill medicare on his behalf.
Entity Name | Sanford Health Network North |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1386047355 PECOS PAC ID: 8022206663 Enrollment ID: O20180205002429 |
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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 Mark Andre Dupont 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 Mark Andre Dupont, MA LP LADC Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-9419 | Mr Mark Andre Dupont, MA LP LADC 3001 Sanford Pkwy, Thief River Falls, MN 56701-2700 Ph: (218) 681-4747 |
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