Kimberly Chantelle Diah, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Iowa City, Iowa. Her current practice location is
200 Hawkins Dr, Iowa City, Iowa. You can reach out to her office (for appointments etc.) via phone at
(319) 356-2671.
Kimberly Chantelle Diah is licensed to practice in Iowa (license number 114355) 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 1619521465.
Healthcare Provider's Profile
| Full Name | Kimberly Chantelle Diah |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 200 Hawkins Dr, Iowa City, Iowa |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619521465
- Provider Enumeration Date: 07/30/2019
- Last Update Date: 10/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 4385076744
- Enrollment ID: I20221011000319
Medical Identifiers
Medical identifiers for Kimberly Chantelle Diah such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619521465 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 114355 (Iowa) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2925 (Kansas) | Secondary |
| 103TC0700X | Psychologist - Clinical | 114355 (Iowa) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 114355 (Iowa) | 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. Kimberly Chantelle Diah allows following entities to bill medicare on her behalf.
| Entity Name | State University Of Iowa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477554814
PECOS PAC ID: 7618884230
Enrollment ID: O20031107000060 |
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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. Kimberly Chantelle Diah 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 |
|---|
Kimberly Chantelle Diah, PHD
200 Hawkins Dr,
Iowa City, IA 52242-1009
Ph: (319) 356-2671 | Kimberly Chantelle Diah, PHD
200 Hawkins Dr,
Iowa City, IA 52242-1009
Ph: (319) 356-2671 |
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