Nicole H Wyngarden, TLLP in Grand Rapids, MI - Medicare Psychologist Provider

Nicole H Wyngarden, TLLP is a medicare enrolled "Psychologist" provider in Grand Rapids, Michigan. Her current practice location is 3225 N Evergreen Dr Ne, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at (616) 364-1500.

Nicole H Wyngarden is licensed to practice in Michigan (license number 6301015679) 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 1265795934.

Contact Information

	Nicole H Wyngarden, TLLP
	3225 N Evergreen Dr Ne, Grand Rapids, MI 49525-9334
	(616) 364-1500
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole H Wyngarden
Gender	Female
Speciality	Psychologist
Location	3225 N Evergreen Dr Ne, Grand Rapids, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265795934
Provider Enumeration Date: 06/19/2012
Last Update Date: 08/28/2013

Medicare PECOS Information:

PECOS PAC ID: 9032338314
Enrollment ID: I20140918001306

Medical Identifiers

Medical identifiers for Nicole H Wyngarden such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265795934	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	6301015103 (Michigan)	Secondary
103T00000X	Psychologist	6301015679 (Michigan)	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. Nicole H Wyngarden allows following entities to bill medicare on her behalf.

Entity Name	Pine Rest Christian Mental Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780695411 PECOS PAC ID: 4981506508 Enrollment ID: O20040213000149

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. Nicole H Wyngarden 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
Nicole H Wyngarden, TLLP 300 68th St Se, Grand Rapids, MI 49548-6927 Ph: (616) 455-5000	Nicole H Wyngarden, TLLP 3225 N Evergreen Dr Ne, Grand Rapids, MI 49525-9334 Ph: (616) 364-1500

Reviews and Comments

Psychologist in Grand Rapids, MI

Dynetta Clark, MA, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 805 Leonard St Ne, Grand Rapids, MI 49503 Phone: 616-451-2021 Fax: 616-774-1001
Mrs. Amy E Pugh, PSYD Psychologist Medicare: Medicare Enrolled Practice Location: 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503 Phone: 616-267-2830 Fax: 616-267-9024
Meghan Cytacki-lewis, MA, TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 333 Bridge St Nw Ste 1120, Grand Rapids, MI 49504 Phone: 616-805-3660
Michelle Marie Muenzenmeyer, LLP, CHMC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2020 Raybrook St Se Ste 102-1, Grand Rapids, MI 49546 Phone: 616-795-0900 Fax: 616-795-0899
Jehricole Olenzuk, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 829 Forest Hill Ave Se, Grand Rapids, MI 49546 Phone: 616-949-2410
Adrian Hernandez, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 360 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49506 Phone: 616-805-3660
Marcia Hollingsworth, EDD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1870 Leonard Ne, Grand Rapids, MI 49505 Phone: 616-956-1122 Fax: 616-956-8033

Nicole H Wyngarden, TLLP - Medicare Psychologist in Grand Rapids, MI