Amanda Maxwell Decrow, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Charlotte, North Carolina. Her current practice location is
1001 Blythe Blvd, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(704) 355-0101.
Amanda Maxwell Decrow is licensed to practice in North Carolina (license number 5259) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144504465.
Healthcare Provider's Profile
| Full Name | Amanda Maxwell Decrow |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1001 Blythe Blvd, Charlotte, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1144504465
- Provider Enumeration Date: 10/05/2011
- Last Update Date: 07/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 4385876523
- Enrollment ID: I20180208001274
Medical Identifiers
Medical identifiers for Amanda Maxwell Decrow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144504465 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 5259 (North Carolina) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 5259 (North Carolina) | 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. Amanda Maxwell Decrow allows following entities to bill medicare on her behalf.
| Entity Name | Carolinas Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275774333
PECOS PAC ID: 4789597477
Enrollment ID: O20031110000116 |
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| Entity Name | The Charlotte-mecklenburg Hospital Authority |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669738829
PECOS PAC ID: 2961310685
Enrollment ID: O20100309000605 |
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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. Amanda Maxwell Decrow 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 |
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Amanda Maxwell Decrow, PHD
Po Box 19305,
Charlotte, NC 28219-9305
Ph: () - | Amanda Maxwell Decrow, PHD
1001 Blythe Blvd,
Charlotte, NC 28203-5866
Ph: (704) 355-0101 |
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