Kerri N Boutelle, PHD in La Jolla, CA - Medicare Psychologist Provider

Kerri N Boutelle, PHD is a medicare enrolled "Psychologist - Clinical" provider in La Jolla, California. Her current practice location is 9500 Gilman Drive Mc 0985, University Of California San Diego, La Jolla, California. You can reach out to her office (for appointments etc.) via phone at (858) 534-8037.

Kerri N Boutelle is licensed to practice in California (license number PSY21823) 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 1780620906.

Contact Information

	Kerri N Boutelle, PHD
	9500 Gilman Drive Mc 0985, University Of California San Diego, La Jolla, CA 92093
	(858) 534-8037
	(858) 534-6727

Map and Direction

Healthcare Provider's Profile

Full Name	Kerri N Boutelle
Gender	Female
Speciality	Psychologist - Clinical
Location	9500 Gilman Drive Mc 0985, La Jolla, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780620906
Provider Enumeration Date: 06/22/2006
Last Update Date: 07/22/2019

Medicare PECOS Information:

PECOS PAC ID: 3072841873
Enrollment ID: I20190816002703

Medical Identifiers

Medical identifiers for Kerri N Boutelle such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780620906	NPI	-	NPPES
123420	Other	MN	UCARE
205A4BO	Other	MN	BCBS
923517500	Medicaid	MN
10387	Other	ND	ND MA
61-60634	Other	MN	MEDICA CHOICE & PRIMARY
839397	Other	MN	ARAZ
7777470	Medicaid	SD
0491997	Medicaid	MT
1019785	Other	MN	PREFERRED ONE
39136900	Other	WI	WI MA
HP34903	Other	MN	HEALTHPARTNERS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY21823 (California)	Primary
103TC2200X	Psychologist - Clinical Child & Adolescent	PSY21823 (California)	Secondary

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. Kerri N Boutelle allows following entities to bill medicare on her behalf.

Entity Name	Regents Of The University Of California
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508968967 PECOS PAC ID: 3577476761 Enrollment ID: O20031203000756

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. Kerri N Boutelle 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
Kerri N Boutelle, PHD Po Box 232410, San Diego, CA 92193-2410 Ph: (858) 249-6748	Kerri N Boutelle, PHD 9500 Gilman Drive Mc 0985, University Of California San Diego, La Jolla, CA 92093 Ph: (858) 534-8037

Reviews and Comments

Psychologist in La Jolla, CA

Dr. Rebecca Clement, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 7514 Girard Ave Ste 3, La Jolla, CA 92037 Phone: 858-213-1014
Paul Santero, Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3252 Holiday Ct Ste 205, La Jolla, CA 92037 Phone: 619-750-0970
Ms. Zona C Lai, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2037 Torrey Pines Rd, La Jolla, CA 92037 Phone: 858-551-8360 Fax: 858-551-8360
Timmie Pollock, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 8950 Villa La Jolla Dr, Suite B204, La Jolla, CA 92037 Phone: 858-452-5700 Fax: 858-452-2012
Dr. Frank J Altobello, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4180 La Jolla Village Dr, Ste 250, La Jolla, CA 92037 Phone: 850-452-3588 Fax: 850-452-3589
Cher S. Rafiee, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7660 Fay Avenue, Suite H #193, La Jolla, CA 92037 Phone: 619-813-2474
Dr. Manuel David Tobias, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3252 Holiday Ct, Ste 227, La Jolla, CA 92037 Phone: 858-362-8779 Fax: 858-455-5556

Kerri N Boutelle, PHD - Medicare Psychologist in La Jolla, CA