Dr Mildred L Blackford, PHD in Crown Point, IN - Medicare Psychologist Provider

Dr Mildred L Blackford, PHD is a medicare enrolled "Psychologist - Clinical" provider in Crown Point, Indiana. Her current practice location is 2100 N Main St # 304, Crown Point, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 546-1900.

Dr Mildred L Blackford is licensed to practice in Indiana (license number 20040531A) 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 1740282110.

Contact Information

	Dr Mildred L Blackford, PHD
	2100 N Main St # 304, Crown Point, IN 46307-1877
	(574) 546-1900
	(574) 546-1999

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mildred L Blackford
Gender	Female
Speciality	Psychologist - Clinical
Location	2100 N Main St # 304, Crown Point, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740282110
Provider Enumeration Date: 08/15/2005
Last Update Date: 07/10/2024

Medicare PECOS Information:

PECOS PAC ID: 9830109495
Enrollment ID: I20160329001594

Medical Identifiers

Medical identifiers for Dr Mildred L Blackford such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740282110	NPI	-	NPPES
148297000	Other	IN	MAGELLAN
226467	Other	IN	MHN
100339990C	Medicaid	IN
11383545	Other	IN	CAQH
000000182274	Other	IN	BCBS
000000006038	Other	IN	MPLAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	20040561A (Indiana)	Secondary
103TC0700X	Psychologist - Clinical	20040531A (Indiana)	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 Mildred L Blackford allows following entities to bill medicare on her behalf.

Entity Name	Indiana University Health Care Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902032832 PECOS PAC ID: 5799755864 Enrollment ID: O20040727000955

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 Mildred L Blackford 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 Mildred L Blackford, PHD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () -	Dr Mildred L Blackford, PHD 2100 N Main St # 304, Crown Point, IN 46307-1877 Ph: (574) 546-1900

Reviews and Comments

Psychologist in Crown Point, IN

Kathy Ann Cain, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2150 W 97th Pl, Crown Point, IN 46307 Phone: 219-808-5140
Adamantia Dina Leftakis, ED.S Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1115 Ziegfield Ct, Crown Point, IN 46307 Phone: 219-308-2454
Dr. Alexander C. Kristevski, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9330 S Broadway, Abj-va Outpatient Clinic, Crown Point, IN 46307 Phone: 219-662-5098
Robin Christian Shear, PH.D., HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999
Jonathan Royce Vandervlugt, LMHCA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9614 Granada Ct Apt 111, Crown Point, IN 46307 Phone: 773-732-1155
Dr. Victoria Colanese, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900
James Fenstermacher, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999

Dr Mildred L Blackford, PHD - Medicare Psychologist in Crown Point, IN