Dr Sydjea M Green, PHD in Southlake, TX - Medicare Psychologist Provider

Dr Sydjea M Green, PHD is a medicare enrolled "Psychologist" provider in Southlake, Texas. Her current practice location is 1230 N Kimball Ave Ste 130, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (833) 667-7924.

Dr Sydjea M Green is licensed to practice in Texas (license number 39576) 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 1750004248.

Contact Information

	Dr Sydjea M Green, PHD
	1230 N Kimball Ave Ste 130, Southlake, TX 76092-4707
	(833) 667-7924
	(817) 755-0945

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Sydjea M Green
Gender	Female
Speciality	Psychologist
Location	1230 N Kimball Ave Ste 130, Southlake, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750004248
Provider Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022

Medicare PECOS Information:

PECOS PAC ID: 2961848197
Enrollment ID: I20240311002597

Medical Identifiers

Medical identifiers for Dr Sydjea M Green such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750004248	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	39576 (Texas)	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 Sydjea M Green allows following entities to bill medicare on her behalf.

Entity Name	Shiny Triangle Lcsw Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164175105 PECOS PAC ID: 1254727480 Enrollment ID: O20220414002466

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 Sydjea M Green 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 Sydjea M Green, PHD 126 Floyd St, Brentwood, NY 11717-2646 Ph: (631) 336-0695	Dr Sydjea M Green, PHD 1230 N Kimball Ave Ste 130, Southlake, TX 76092-4707 Ph: (833) 667-7924

Reviews and Comments

Psychologist in Southlake, TX

Dr. Ashley Harrison Noble, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 211 E Southlake Blvd Ste 101, Southlake, TX 76092 Phone: 817-488-3538
Dr. Kate Stark, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 200, Southlake, TX 76092 Phone: 682-292-7012
Ryan Edward Holt, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 200, Southlake, TX 76092 Phone: 682-292-7012
Ms. Avni Vyas, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10725 East Southlake Blvd, 102, Southlake, TX 76092 Phone: 817-618-9307 Fax: 817-977-8553
Dr. Wyatt R Evans, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 120, Southlake, TX 76092 Phone: 940-368-2664
Dr. Sarah Helen Thomas Randel, PHD PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 250 W Southlake Blvd, Suite 208, Southlake, TX 76092 Phone: 817-988-9472 Fax: 817-379-1731
Dr. April Minatrea, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 211 E Southlake Blvd, Suite 115, Southlake, TX 76092 Phone: 817-404-7999

Dr Sydjea M Green, PHD - Medicare Psychologist in Southlake, TX