Dr Kyle David Raque, PSYD in Blue Ridge, GA - Medicare Clinical Psychologist Provider

Dr Kyle David Raque, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Blue Ridge, Georgia. He graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Blue Ridge Psychological Services, Llc and his current practice location is 9757 Blue Ridge Dr, Blue Ridge, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 455-2490.

Dr Kyle David Raque is licensed to practice in Georgia (license number PSY003039) 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 1790863900.

Contact Information

	Dr Kyle David Raque, PSYD
	9757 Blue Ridge Dr, Blue Ridge, GA 30513-4167
	(706) 455-2490
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kyle David Raque
Gender	Male
Speciality	Clinical Psychologist
Experience	19 Years
Location	9757 Blue Ridge Dr, Blue Ridge, Georgia
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 Kyle David Raque graduated from medical school in 2005

NPI Data:

NPI Number: 1790863900
Provider Enumeration Date: 11/02/2006
Last Update Date: 02/26/2020

Medicare PECOS Information:

PECOS PAC ID: 0345262481
Enrollment ID: I20070215000010

Medical Identifiers

Medical identifiers for Dr Kyle David Raque such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790863900	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY003039 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Blue Ridge Psychological Services, Llc	1759428063	2

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 Kyle David Raque allows following entities to bill medicare on his behalf.

Entity Name	Blue Ridge Psychological Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750524781 PECOS PAC ID: 1759428063 Enrollment ID: O20091019000599

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 Kyle David Raque 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 Kyle David Raque, PSYD 9757 Blue Ridge Dr, Blue Ridge, GA 30513-4167 Ph: (706) 455-2490	Dr Kyle David Raque, PSYD 9757 Blue Ridge Dr, Blue Ridge, GA 30513-4167 Ph: (706) 455-2490

Reviews and Comments

Psychologist in Blue Ridge, GA

Dr. Kenneth Neal, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 101 Riverstone Vis 211, Blue Ridge, GA 30513 Phone: 706-632-3670 Fax: 706-632-3585
Esther Jean-gratia, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 9757 Blue Ridge Dr, Blue Ridge, GA 30513 Phone: 706-455-2490
Dr. Alvin Ronald Seifert, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 9757 Blue Ridge Dr, Blue Ridge, GA 30513 Phone: 706-455-2490 Fax: 706-946-6574
Willa Boston, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9757 Blue Ridge Dr, Blue Ridge, GA 30513 Phone: 706-455-2490 Fax: 706-946-6574
Dr. Kenneth Bradford Carpenter, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 165 Blue Ridge Overlook, Blue Ridge, GA 30513 Phone: 706-946-4647 Fax: 706-374-5006

Dr Kyle David Raque, PSYD - Medicare Psychologist in Blue Ridge, GA