Mr Mickey Marshall, in Berkeley, CA - Medicare Psychologist Provider

Mr Mickey Marshall, is a medicare enrolled "Psychologist - School" provider in Berkeley, California. His current practice location is 3200 Adeline St, Berkeley, California. You can reach out to his office (for appointments etc.) via phone at (510) 601-0203.

Mr Mickey Marshall is licensed to practice in * (Not Available) (license number ) 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 1992913495.

Contact Information

	Mr Mickey Marshall,
	3200 Adeline St, Berkeley, CA 94703-2407
	(510) 601-0203
	(510) 601-4002

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Mickey Marshall
Gender	Male
Speciality	Psychologist - School
Location	3200 Adeline St, Berkeley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992913495
Provider Enumeration Date: 05/18/2007
Last Update Date: 01/03/2022

Medicare PECOS Information:

PECOS PAC ID: 8527337369
Enrollment ID: I20170710002788

Medical Identifiers

Medical identifiers for Mr Mickey Marshall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992913495	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TS0200X	Psychologist - School	(* (Not Available))	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 Mickey Marshall allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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 Mickey Marshall 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 Mickey Marshall, 3200 Adeline St, Berkeley, CA 94703-2407 Ph: (510) 601-0203	Mr Mickey Marshall, 3200 Adeline St, Berkeley, CA 94703-2407 Ph: (510) 601-0203

Reviews and Comments

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Mr Mickey Marshall, - Medicare Psychologist in Berkeley, CA