Mr Michael Joseph Gillen, PHD is a medicare enrolled "Psychologist - Clinical" provider in Union Grove, Wisconsin. His current practice location is
21425 Spring Street, Union Grove Va Clinic, Union Grove, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 878-7020.
Mr Michael Joseph Gillen is licensed to practice in Wisconsin (license number 3313-57) 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 1477925121.
Healthcare Provider's Profile
Full Name | Mr Michael Joseph Gillen |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 21425 Spring Street, Union Grove, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1477925121
- Provider Enumeration Date: 10/21/2015
- Last Update Date: 11/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 1052609906
- Enrollment ID: I20161010002131
Medical Identifiers
Medical identifiers for Mr Michael Joseph Gillen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477925121 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 3313-57 (Wisconsin) | 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. Mr Michael Joseph Gillen allows following entities to bill medicare on his behalf.
Entity Name | Davken Associates, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1457393159 PECOS PAC ID: 8820901861 Enrollment ID: O20031106000631 |
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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. Mr Michael Joseph Gillen 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 |
Mr Michael Joseph Gillen, PHD 21425 Spring Street, Union Grove Va Clinic, Union Grove, WI 53182 Ph: (262) 878-7020 | Mr Michael Joseph Gillen, PHD 21425 Spring Street, Union Grove Va Clinic, Union Grove, WI 53182 Ph: (262) 878-7020 |
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