Dr Kevin Joseph Nissen, PHD in Northport, NY - Medicare Psychologist Provider

Dr Kevin Joseph Nissen, PHD is a medicare enrolled "Psychologist" provider in Northport, New York. His current practice location is 79 Middleville Rd, Northport, New York. You can reach out to his office (for appointments etc.) via phone at (631) 261-4400.

Dr Kevin Joseph Nissen is licensed to practice in * (Not Available) (license number ) 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 1245093616.

Contact Information

	Dr Kevin Joseph Nissen, PHD
	79 Middleville Rd, Northport, NY 11768-2200
	(631) 261-4400
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kevin Joseph Nissen
Gender	Male
Speciality	Psychologist
Location	79 Middleville Rd, Northport, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245093616
Provider Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024

Medicare PECOS Information:

PECOS PAC ID: 6103351572
Enrollment ID: I20241121002713

Medical Identifiers

Medical identifiers for Dr Kevin Joseph Nissen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245093616	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	(* (Not Available))	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 Kevin Joseph Nissen allows following entities to bill medicare on his behalf.

Entity Name	North Shore - Lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

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 Kevin Joseph Nissen 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 Kevin Joseph Nissen, PHD Po Box 34, Holtsville, NY 11742-0034 Ph: (631) 578-9526	Dr Kevin Joseph Nissen, PHD 79 Middleville Rd, Northport, NY 11768-2200 Ph: (631) 261-4400

Reviews and Comments

Psychologist in Northport, NY

Dr. Janet Ellen Eschen, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: Northport Vamc Psychology Service (116b), 79 Middleville Road, Northport, NY 11768 Phone: 631-261-4400 Fax: 631-266-6086
Dr. Michelle Anne Castellano, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 79 Middleville Rd, Northport, NY 11768 Phone: 631-261-4400
Qian Li, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 79 Middleville Road, Northport, NY 11768 Phone: 631-261-4400
Dr. Tara A. Maddalena, PSY. D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 256 Main St, Suite 1108, Northport, NY 11768 Phone: 631-901-2640
Dr. Rebecca Lazzaro, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 79 Middleville Rd, Northport, NY 11768 Phone: 631-261-4400
Dr. Donna Kathy Nissman, PSYD Psychologist Medicare: May Accept Medicare Assignments Practice Location: 55 Sandy Hollow Rd, Northport, NY 11768 Phone: 631-261-3958
Dr. Linda Frances Fazio, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 16 Woody Ln, Northport, NY 11768 Phone: 631-754-2235

Dr Kevin Joseph Nissen, PHD - Medicare Psychologist in Northport, NY