Dr Keith James Fallon, PSYD in Conyers, GA - Medicare Psychologist Provider

Dr Keith James Fallon, PSYD is a medicare enrolled "Psychologist" provider in Conyers, Georgia. His current practice location is 1100 Green St Sw, Conyers, Georgia. You can reach out to his office (for appointments etc.) via phone at (404) 502-5824.

Dr Keith James Fallon is licensed to practice in Georgia (license number PSY002856) 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 1770635401.

Contact Information

	Dr Keith James Fallon, PSYD
	1100 Green St Sw, Conyers, GA 30012-5220
	(404) 502-5824
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Keith James Fallon
Gender	Male
Speciality	Psychologist
Location	1100 Green St Sw, Conyers, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770635401
Provider Enumeration Date: 01/16/2007
Last Update Date: 01/21/2015

Medicare PECOS Information:

PECOS PAC ID: 7618281510
Enrollment ID: I20150806009919

Medical Identifiers

Medical identifiers for Dr Keith James Fallon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770635401	NPI	-	NPPES
375822929A	Medicaid	GA
375822929B	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	PSY002856 (Georgia)	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 Keith James Fallon allows following entities to bill medicare on his behalf.

Entity Name	Keith Fallon, Psy.d., P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801947569 PECOS PAC ID: 6800100702 Enrollment ID: O20150806009886

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 Keith James Fallon 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 Keith James Fallon, PSYD Po Box 1790, Conyers, GA 30012-7964 Ph: (404) 502-5824	Dr Keith James Fallon, PSYD 1100 Green St Sw, Conyers, GA 30012-5220 Ph: (404) 502-5824

Reviews and Comments

Psychologist in Conyers, GA

Dr. Robert Tyre Jones Iv, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1397 Manchester Dr Ne, Conyers, GA 30012 Phone: 770-483-6377 Fax: 770-929-0902
Dr. Janell H Brooks, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1500 Klondike Rd Sw Ste A103, Conyers, GA 30094 Phone: 678-671-5279 Fax: 678-562-2297
Dr. Shenell Myrie, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 1825 Parker Rd Se Apt 1010, Conyers, GA 30094 Phone: 718-644-2691
Dr. Gail Mayshark, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 1807 Over Lake Dr Se, St.c, Conyers, GA 30013 Phone: 770-922-6921 Fax: 770-934-2105
Dr. Charles Bartholomew, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2385 Wall Street, Wall Street Executive Suites, Conyers, GA 30013 Phone: 770-820-3181
Dr. Quanta R Speight, Psychologist Medicare: Not Enrolled in Medicare Practice Location: Po Box 83351, Conyers, GA 30013 Phone: 678-713-0495
Mr. Douglas Robert Slavin, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1100 Green St Sw, Conyers, GA 30012 Phone: 404-834-1513 Fax: 770-783-8001

Dr Keith James Fallon, PSYD - Medicare Psychologist in Conyers, GA