Dr Lissette Carmona-roman, PSYD in Davenport, FL - Medicare Psychologist Provider

Dr Lissette Carmona-roman, PSYD is a medicare enrolled "Psychologist" provider in Davenport, Florida. Her current practice location is 521 Brunswick Dr, Davenport, Florida. You can reach out to her office (for appointments etc.) via phone at (347) 480-6490.

Dr Lissette Carmona-roman is licensed to practice in Florida (license number PY11323) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1861718975.

Contact Information

	Dr Lissette Carmona-roman, PSYD
	521 Brunswick Dr, Davenport, FL 33837-4609
	(347) 480-6490
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Lissette Carmona-roman
Gender	Female
Speciality	Psychologist
Location	521 Brunswick Dr, Davenport, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861718975
Provider Enumeration Date: 04/14/2010
Last Update Date: 11/14/2022

Medicare PECOS Information:

PECOS PAC ID: 5991169484
Enrollment ID: I20230918000964

Medical Identifiers

Medical identifiers for Dr Lissette Carmona-roman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861718975	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	3509 (Puerto Rico)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
103T00000X	Psychologist	PY11323 (Florida)	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 Lissette Carmona-roman allows following entities to bill medicare on her behalf.

Entity Name	Refresh Canopy Cove, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730661752 PECOS PAC ID: 3779822119 Enrollment ID: O20190304000354

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 Lissette Carmona-roman 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 Lissette Carmona-roman, PSYD 521 Brunswick Dr, Davenport, FL 33837-4609 Ph: (347) 480-6490	Dr Lissette Carmona-roman, PSYD 521 Brunswick Dr, Davenport, FL 33837-4609 Ph: (347) 480-6490

Reviews and Comments

Psychologist in Davenport, FL

Erika Camacho, PSICOLOGO Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1016 Laguna Loop Unit 410, Davenport, FL 33896 Phone: 321-340-1880
Sandra M Ballester, PSY. D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 602 Coventry Rd, Davenport, FL 33897 Phone: 863-424-0194
Jenniffer Gonzalez, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 560 Westchester Ct, Davenport, FL 33837 Phone: 863-521-0893
Schermika Yarise Velez, OTHER Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1467 Fox Squirrel Dr, Davenport, FL 33897 Phone: 321-926-5974
Linda Richardson, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 416 Granada Blvd, Davenport, FL 33837 Phone: 510-363-7264
Michalina Giovanna Montalto, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2802 Rws Ranch Rd, Davenport, FL 33837 Phone: 863-368-7538
Jorge David Rodriguez, MD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1467 Fox Squirrel Dr, Davenport, FL 33897 Phone: 863-326-8128

Dr Lissette Carmona-roman, PSYD - Medicare Psychologist in Davenport, FL