Dr Jeremy Ray Sullivan, PSYD in Bennington, VT - Medicare Psychologist Provider

Dr Jeremy Ray Sullivan, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Bennington, Vermont. His current practice location is 655 Main St, Bennington, Vermont. You can reach out to his office (for appointments etc.) via phone at (413) 347-6679.

Dr Jeremy Ray Sullivan is licensed to practice in Vermont (license number 04800000878) 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 1043441306.

Contact Information

	Dr Jeremy Ray Sullivan, PSYD
	655 Main St, Bennington, VT 05201-2870
	(413) 347-6679
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jeremy Ray Sullivan
Gender	Male
Speciality	Psychologist - Clinical
Location	655 Main St, Bennington, Vermont
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043441306
Provider Enumeration Date: 08/05/2009
Last Update Date: 08/05/2009

Medicare PECOS Information:

PECOS PAC ID: 8820134141
Enrollment ID: I20090930000059

Medical Identifiers

Medical identifiers for Dr Jeremy Ray Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043441306	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	04800000878 (Vermont)	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. Dr Jeremy Ray Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Medoptions Of Vermont Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114479730 PECOS PAC ID: 0547541260 Enrollment ID: O20170111000999

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 Jeremy Ray Sullivan 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 Jeremy Ray Sullivan, PSYD 342 Lesure Rd, Stamford, VT 05352-9569 Ph: (802) 694-1994	Dr Jeremy Ray Sullivan, PSYD 655 Main St, Bennington, VT 05201-2870 Ph: (413) 347-6679

Reviews and Comments

Psychologist in Bennington, VT

Bernard M Bandman, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 160 Benmont Ave, Bennington, VT 05201 Phone: 802-447-0037 Fax: 802-442-8721
Laura Budde, LICSW Psychologist Medicare: Not Enrolled in Medicare Practice Location: 100 Ledgehill Rd, Bennington, VT 05201 Phone: 802-442-5491 Fax: 802-442-4910
Barbara M Hand, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 100 Ledgehill Rd, Bennington, VT 05201 Phone: 802-442-5491
Doris M Russell, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 100 Ledgehill Rd, Bennington, VT 05201 Phone: 802-442-5491 Fax: 802-442-3363
Jennifer Romans Burgoon, PHD, Psychologist Medicare: Accepting Medicare Assignments Practice Location: 160 Hospital Dr, Bennington, VT 05201 Phone: 210-615-3483
Paul Stitelman, LICSW Psychologist Medicare: Not Enrolled in Medicare Practice Location: 100 Ledgehill Rd, Bennington, VT 05201 Phone: 802-442-5491 Fax: 802-442-4910

Dr Jeremy Ray Sullivan, PSYD - Medicare Psychologist in Bennington, VT