Dusty Renee Hackler, PHD in Maple Grove, MN - Medicare Psychologist Provider

Dusty Renee Hackler, PHD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Maple Grove, Minnesota. Her current practice location is 9555 Upland Ln N, Maple Grove, Minnesota. You can reach out to her office (for appointments etc.) via phone at (952) 993-3307.

Dusty Renee Hackler is licensed to practice in Minnesota (license number LP6194) 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 1487168357.

Contact Information

	Dusty Renee Hackler, PHD
	9555 Upland Ln N, Maple Grove, MN 55369-4485
	(952) 993-3307
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dusty Renee Hackler
Gender	Female
Speciality	Psychologist - Clinical Child & Adolescent
Location	9555 Upland Ln N, Maple Grove, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487168357
Provider Enumeration Date: 11/29/2017
Last Update Date: 11/29/2017

Medicare PECOS Information:

PECOS PAC ID: 9739447699
Enrollment ID: I20171222000441

Medical Identifiers

Medical identifiers for Dusty Renee Hackler such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487168357	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	LP6194 (Minnesota)	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. Dusty Renee Hackler allows following entities to bill medicare on her behalf.

Entity Name	Park Nicollet Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046

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. Dusty Renee Hackler 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
Dusty Renee Hackler, PHD 9555 Upland Ln N, Mailstop:62m03b, Maple Grove, MN 55369-4485 Ph: (952) 993-3307	Dusty Renee Hackler, PHD 9555 Upland Ln N, Maple Grove, MN 55369-4485 Ph: (952) 993-3307

Reviews and Comments

Psychologist in Maple Grove, MN

Michelle K. Pemble-frazey, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 9555 Upland Ln N, Maple Grove, MN 55369 Phone: 952-993-1440
Sally Rose Brinza, PHD LP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7225 Forestview Ln N, Maple Grove, MN 55369 Phone: 612-978-5058 Fax: 763-201-1095
Dr. Michaela Monetti, PH.D., LP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1000
Dr. Jennifer G Enstad, PSY.D., L.P. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7372 Kirkwood Ct, Maple Grove, MN 55369 Phone: 763-416-4167 Fax: 763-416-4137
Dr. Matthew Kingsbury, PSYD, LP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 11316 86th Ave N, Maple Grove, MN 55369 Phone: 763-400-8000 Fax: 763-400-8000
Dr. Rochelle Elizabeth Mccourtney Gredvig, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120
Dr. Teresa Biehn, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 9555 Upland Ln N, Maple Grove, MN 55369 Phone: 952-993-1440

Dusty Renee Hackler, PHD - Medicare Psychologist in Maple Grove, MN