Dr Nicole I Medina, PSYD in Murray, UT - Medicare Psychologist Provider

Dr Nicole I Medina, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Murray, Utah. Her current practice location is 5965 S 900 E, Murray, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 872-5516.

Dr Nicole I Medina is licensed to practice in Utah (license number 10158726-2501) 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 1235488008.

Contact Information

	Dr Nicole I Medina, PSYD
	5965 S 900 E, Murray, UT 84121-1757
	(801) 872-5516
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Nicole I Medina
Gender	Female
Speciality	Psychologist - Clinical
Location	5965 S 900 E, Murray, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235488008
Provider Enumeration Date: 09/07/2012
Last Update Date: 08/11/2023

Medicare PECOS Information:

PECOS PAC ID: 6800212861
Enrollment ID: I20200820002747

Medical Identifiers

Medical identifiers for Dr Nicole I Medina such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235488008	NPI	-	NPPES
10158726-2501	Other	UT	PROFESSIONAL LICENSE
1235488008	Medicaid	UT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	10158726-2501 (Utah)	Primary
103T00000X	Psychologist	10158726-2501 (Utah)	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 Nicole I Medina allows following entities to bill medicare on her behalf.

Entity Name	Neurobehavioral Center For Growth Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942641931 PECOS PAC ID: 4183859622 Enrollment ID: O20131108000961

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 Nicole I Medina 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 Nicole I Medina, PSYD 5965 S 900 E Ste 100, Murray, UT 84121-1850 Ph: (801) 872-5516	Dr Nicole I Medina, PSYD 5965 S 900 E, Murray, UT 84121-1757 Ph: (801) 872-5516

Reviews and Comments

Psychologist in Murray, UT

Denise Marie Boelens, PH.D. Psychologist Medicare: May Accept Medicare Assignments Practice Location: 5801 Fashion Blvd, Suite 250, Murray, UT 84107 Phone: 801-596-0147
Dr. Alyssa Bee Levy, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 842 Three Fountains Dr, Murray, UT 84107 Phone: 801-963-4292 Fax: 801-963-4299
Dr. Matthew V. Davies, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5353 S 960 E, Suite 230, Murray, UT 84117 Phone: 801-263-3335 Fax: 801-263-2845
Nathanael W Ridge, PA, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5770 S 250 E, #290, Murray, UT 84107 Phone: 801-747-8700 Fax: 801-747-8701
Diego Gonzalo Flores, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 111 E 5600 S Ste 304, Murray, UT 84107 Phone: 801-272-3420
Samantha Allison, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 5121 S Cottonwood St, Murray, UT 84107 Phone: 314-218-8932

Dr Nicole I Medina, PSYD - Medicare Psychologist in Murray, UT