Carson Teague, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Detroit, Michigan. His current practice location is
261 Mack Ave Ste 555, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 745-9763.
Carson Teague is licensed to practice in Michigan (license number 6301019342) 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 1447024617.
Healthcare Provider's Profile
| Full Name | Carson Teague |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 261 Mack Ave Ste 555, Detroit, Michigan |
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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: 1447024617
- Provider Enumeration Date: 11/08/2023
- Last Update Date: 02/03/2025
Medicare PECOS Information:
- PECOS PAC ID: 1759825573
- Enrollment ID: I20240703000556
Medical Identifiers
Medical identifiers for Carson Teague such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447024617 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 6301019342 (Michigan) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 6301019342 (Michigan) | 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. Carson Teague allows following entities to bill medicare on his behalf.
| Entity Name | Vhs Physicians Of Michigan |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073827101
PECOS PAC ID: 8921289760
Enrollment ID: O20110225000849 |
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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. Carson Teague 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 |
|---|
Carson Teague, PHD
261 Mack Ave Ste 555,
Detroit, MI 48201-2417
Ph: (313) 745-9763 | Carson Teague, PHD
261 Mack Ave Ste 555,
Detroit, MI 48201-2417
Ph: (313) 745-9763 |
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