Elissa D Wilburn, PHD in Little Rock, AR - Medicare Psychologist Provider

Elissa D Wilburn, PHD is a medicare enrolled "Psychologist - Clinical" provider in Little Rock, Arkansas. Her current practice location is 1210 Wolfe St, Little Rock, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 364-5150.

Elissa D Wilburn is licensed to practice in Arkansas (license number 202163) 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 1669969861.

Contact Information

	Elissa D Wilburn, PHD
	1210 Wolfe St, Little Rock, AR 72202-4618
	(501) 364-5150
	(501) 364-6966

Map and Direction

Healthcare Provider's Profile

Full Name	Elissa D Wilburn
Gender	Female
Speciality	Psychologist - Clinical
Location	1210 Wolfe St, Little Rock, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669969861
Provider Enumeration Date: 04/13/2018
Last Update Date: 01/31/2022

Medicare PECOS Information:

PECOS PAC ID: 3173938180
Enrollment ID: I20210224000648

Medical Identifiers

Medical identifiers for Elissa D Wilburn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669969861	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	19-31AP-PL (Arkansas)	Secondary
103TC0700X	Psychologist - Clinical	202163 (Arkansas)	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. Elissa D Wilburn allows following entities to bill medicare on her behalf.

Entity Name	University Of Arkansas For Medical Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588654016 PECOS PAC ID: 4082528955 Enrollment ID: O20031219000706

Entity Name	University Of Arkansas For Medical Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346230968 PECOS PAC ID: 4082528955 Enrollment ID: O20040115000431

Entity Name	Arkansas Childrens Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598773079 PECOS PAC ID: 2769477744 Enrollment ID: O20040419000796

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. Elissa D Wilburn 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
Elissa D Wilburn, PHD 4301 W Markham St # 783, Little Rock, AR 72205-7101 Ph: (501) 686-8000	Elissa D Wilburn, PHD 1210 Wolfe St, Little Rock, AR 72202-4618 Ph: (501) 364-5150

Reviews and Comments

Psychologist in Little Rock, AR

Stephen Clark, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10025 W. Markham Street, Ste 210, Little Rock, AR 72205 Phone: 501-663-4673 Fax: 501-801-1816
Mark Edwards, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 800 Marshall St # 653, Little Rock, AR 72202 Phone: 501-364-1100
Dr. Melissa Lee Wright, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1210 Wolfe St, Little Rock, AR 72202 Phone: 501-364-3810 Fax: 501-364-3816
Larry Clarke, PH.D. (PSYCHOLOGIST) Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11219 Financial Centre Pkwy, Suite 310, Little Rock, AR 72211 Phone: 501-224-8393 Fax: 501-224-2849
Mrs. Zenobia Carter, M.S. LPE Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5905 Forest Pl, Little Rock, AR 72207 Phone: 501-666-8686 Fax: 501-660-6838
Brittani Baldwin Gracey, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 305 S Palm St, Little Rock, AR 72205 Phone: 507-686-9000
Laura Goodhart, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 1301 Wolfe St, Little Rock, AR 72202 Phone: 501-372-2768 Fax: 501-978-6492

Elissa D Wilburn, PHD - Medicare Psychologist in Little Rock, AR