Dr Ethan Mccallum, PHD in Plymouth, MN - Medicare Clinical Psychologist Provider

Dr Ethan Mccallum, PHD is a medicare enrolled "Psychologist" provider in Plymouth, Minnesota. He went to University Of Missouri, Kansas City, School Of Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Allina Health System and his current practice location is 2855 Campus Dr Ste 400, Plymouth, Minnesota. You can reach out to his office (for appointments etc.) via phone at (763) 577-7400.

Dr Ethan Mccallum is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1851703110.

Contact Information

	Dr Ethan Mccallum, PHD
	2855 Campus Dr Ste 400, Plymouth, MN 55441-2659
	(763) 577-7400
	(763) 236-2650

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Ethan Mccallum
Gender	Male
Speciality	Clinical Psychologist
Experience	11 Years
Location	2855 Campus Dr Ste 400, Plymouth, Minnesota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Ethan Mccallum attended and graduated from University Of Missouri, Kansas City, School Of Medicine in 2013

NPI Data:

NPI Number: 1851703110
Provider Enumeration Date: 05/21/2014
Last Update Date: 11/10/2020

Medicare PECOS Information:

PECOS PAC ID: 5193097095
Enrollment ID: I20170826000020

Medical Identifiers

Medical identifiers for Dr Ethan Mccallum such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851703110	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	(* (Not Available))	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Allina Health System	4587573613	3101

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 Ethan Mccallum allows following entities to bill medicare on his behalf.

Entity Name	Allina Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295272342 PECOS PAC ID: 4587573613 Enrollment ID: O20040319000460

Entity Name	Allina Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457657249 PECOS PAC ID: 4587573613 Enrollment ID: O20221213001713

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 Ethan Mccallum 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 Ethan Mccallum, PHD 2925 Chicago Ave, Minneapolis, MN 55407-1321 Ph: (612) 262-9000	Dr Ethan Mccallum, PHD 2855 Campus Dr Ste 400, Plymouth, MN 55441-2659 Ph: (763) 577-7400

Reviews and Comments

Psychologist in Plymouth, MN

Christian L Babo, PSY D, LP Psychologist Medicare: May Accept Medicare Assignments Practice Location: 10700 Old County Road 15 Ste 170, Plymouth, MN 55441 Phone: 763-525-8590 Fax: 763-525-8592
Jacquelyn H Baker, MA, LP, LMFT Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2855 Campus Dr, Suite 400, Plymouth, MN 55441 Phone: 612-577-7400 Fax: 612-577-7440
Dr. Gail Ann Thoen, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 12525 42 Avenue North, Plymouth, MN 55441 Phone: 763-551-1518
Dr. Gary D Vikesland, PHD Psychologist Medicare: May Accept Medicare Assignments Practice Location: 10700 Old County Road 15 Ste 170, Plymouth, MN 55441 Phone: 763-525-8590 Fax: 763-525-8592
Teresa A Boatman, PHD, LP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11525 40th Ave N, Plymouth, MN 55441 Phone: 763-234-4974
Dr. Margaret Ann Green, LP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3937 Orchid Ln N, Plymouth, MN 55446 Phone: 763-476-1027
Ms. Melissa Ann Bollinger-kinney, M.S.ED LPC Psychologist Medicare: Medicare Enrolled Practice Location: 3021 Harbor Ln N Ste 206, Plymouth, MN 55447 Phone: 763-559-1640 Fax: 763-559-1617

Dr Ethan Mccallum, PHD - Medicare Psychologist in Plymouth, MN