Kathleen Mccann Deidrick, PHD in Boise, ID - Medicare Psychologist Provider

Kathleen Mccann Deidrick, PHD is a medicare enrolled "Psychologist - Clinical" provider in Boise, Idaho. Her current practice location is 100 E Idaho St, Ste 200, Boise, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 381-5000.

Kathleen Mccann Deidrick is licensed to practice in Idaho (license number PSY202777) 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 1891742540.

Contact Information

	Kathleen Mccann Deidrick, PHD
	100 E Idaho St, Ste 200, Boise, ID 83712-6267
	(208) 381-5000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kathleen Mccann Deidrick
Gender	Female
Speciality	Psychologist - Clinical
Location	100 E Idaho St, Boise, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891742540
Provider Enumeration Date: 05/28/2006
Last Update Date: 02/21/2014

Medicare PECOS Information:

PECOS PAC ID: 4486664737
Enrollment ID: I20191016000603

Medical Identifiers

Medical identifiers for Kathleen Mccann Deidrick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891742540	NPI	-	NPPES
740169	Other	MO	HEALTHLINK
205814	Other	MO	BLUE SHIELD/BLUE CHOICE
491287009	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	2003023860 (Missouri)	Secondary
103TC0700X	Psychologist - Clinical	PSY202777 (Idaho)	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. Kathleen Mccann Deidrick allows following entities to bill medicare on her behalf.

Entity Name	St Lukes Clinic-treasure Valley Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045

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. Kathleen Mccann Deidrick 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
Kathleen Mccann Deidrick, PHD 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 381-2222	Kathleen Mccann Deidrick, PHD 100 E Idaho St, Ste 200, Boise, ID 83712-6267 Ph: (208) 381-5000

Reviews and Comments

Psychologist in Boise, ID

Dr. Barbara Alison Minton, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1403 W Franklin St, Boise, ID 83702 Phone: 208-867-4048
Dr. Winslow Gregory Gerrish, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 777 N Raymond St, Boise, ID 83704 Phone: 208-514-2500 Fax: 208-375-2217
Dr. Ann Decker Trotter, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 500 W Fort St, Boise, ID 83702 Phone: 208-422-1000
Andrea Zambukos, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3324 Elder St., Boise, ID 83705 Phone: 208-333-0008
Mark E. Snow, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 311 N. Allumbaugh St, Boise, ID 83704 Phone: 208-375-6402 Fax: 208-323-1850
Dr. Heidi Rachelle Tennyson, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1755 N Westgate Dr Ste 260, Boise, ID 83704 Phone: 208-373-0790 Fax: 208-373-0816
Dr. Christine Dee Isaacs, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1310 W Hays St, Boise, ID 83702 Phone: 208-343-4208

Kathleen Mccann Deidrick, PHD - Medicare Psychologist in Boise, ID