Dr Mark Daniel Blackhurst, PSYD in Chowchilla, CA - Medicare Psychologist Provider

Dr Mark Daniel Blackhurst, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Chowchilla, California. His current practice location is 21633 Avenue 24, Chowchilla, California. You can reach out to his office (for appointments etc.) via phone at (559) 665-6100.

Dr Mark Daniel Blackhurst is licensed to practice in California (license number PSY28115) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760770192.

Contact Information

	Dr Mark Daniel Blackhurst, PSYD
	21633 Avenue 24, Chowchilla, CA 93610-9650
	(559) 665-6100
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mark Daniel Blackhurst
Gender	Male
Speciality	Psychologist - Clinical
Location	21633 Avenue 24, Chowchilla, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760770192
Provider Enumeration Date: 07/19/2011
Last Update Date: 01/10/2024

Medicare PECOS Information:

PECOS PAC ID: 9739610114
Enrollment ID: I20241009003408

Medical Identifiers

Medical identifiers for Dr Mark Daniel Blackhurst such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760770192	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY28115 (California)	Primary
103TC0700X	Psychologist - Clinical	28115 (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. Dr Mark Daniel Blackhurst allows following entities to bill medicare on his behalf.

Entity Name	Access Psychology Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558752931 PECOS PAC ID: 6204155187 Enrollment ID: O20150427000807

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. Dr Mark Daniel Blackhurst 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
Dr Mark Daniel Blackhurst, PSYD 21633 Avenue 24, Chowchilla, CA 93610-9650 Ph: (559) 665-6100	Dr Mark Daniel Blackhurst, PSYD 21633 Avenue 24, Chowchilla, CA 93610-9650 Ph: (559) 665-6100

Reviews and Comments

Psychologist in Chowchilla, CA

Dr. Andrew Todd Rhodes, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 23370 Road 22, Chowchilla, CA 93610 Phone: 559-992-7100
Dr. Margareta Maria Wiberg X, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 23370 Road 22, Chowchilla, CA 93610 Phone: 559-665-5531 Fax: 559-665-6040
Dr. Sheri Rossi, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 21633 Avenue 24, Chowchilla, CA 93610 Phone: 559-665-6100
Dr. Karla Yareli Ceballos-lopez, ED. D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 805 Humboldt Ave, Chowchilla, CA 93610 Phone: 559-665-1331
Dr. Rachel Michelle Richardson, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 21633 Avenue 24, Chowchilla, CA 93610 Phone: 559-665-6100
Carrie Lynn Ortiz, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 23370 Road 22, Chowchilla, CA 93610 Phone: 559-665-5531
Ethan Abercrombie, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 14005 Spyglass Cir, Chowchilla, CA 93610 Phone: 559-201-9452

Dr Mark Daniel Blackhurst, PSYD - Medicare Psychologist in Chowchilla, CA