Dr Carli Nicole Pruitt, PSYD, JD is a medicare enrolled "Psychologist" provider in Cheverly, Maryland. She graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Premier Health Care Llc and her current practice location is
3001 Hospital Dr, Cheverly, Maryland. You can reach out to her office (for appointments etc.) via phone at
(301) 618-2000.
Dr Carli Nicole Pruitt is licensed to practice in Pennsylvania (license number PS018963) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1053950949.
Healthcare Provider's Profile
Full Name | Dr Carli Nicole Pruitt |
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Gender | Female |
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Speciality | Clinical Psychologist |
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Experience | 6 Years |
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Location | 3001 Hospital Dr, Cheverly, Maryland |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Carli Nicole Pruitt graduated from medical school in 2018
NPI Data:
- NPI Number: 1053950949
- Provider Enumeration Date: 12/26/2019
- Last Update Date: 04/15/2021
Medicare PECOS Information:
- PECOS PAC ID: 8628405446
- Enrollment ID: I20210511000504
Medical Identifiers
Medical identifiers for Dr Carli Nicole Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053950949 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | PS018963 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Premier Health Care Llc | 7618285842 | 17 |
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. Dr Carli Nicole Pruitt allows following entities to bill medicare on her behalf.
Entity Name | Dimensions Healthcare Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1346354834 PECOS PAC ID: 1557269743 Enrollment ID: O20031226000032 |
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Entity Name | Premier Health Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1285017822 PECOS PAC ID: 7618285842 Enrollment ID: O20151008000494 |
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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. Dr Carli Nicole Pruitt 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 |
Dr Carli Nicole Pruitt, PSYD, JD 208 Dairy Rd, Berwick, PA 18603-5819 Ph: (570) 594-7053 | Dr Carli Nicole Pruitt, PSYD, JD 3001 Hospital Dr, Cheverly, MD 20785-1189 Ph: (301) 618-2000 |
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