Priscilla Roth-wall, PHD in Farmington, NM - Medicare Psychologist Provider

Priscilla Roth-wall, PHD is a medicare enrolled "Psychologist - Clinical" provider in Farmington, New Mexico. Her current practice location is 3751 N Butler Ave Ste 115, Farmington, New Mexico. You can reach out to her office (for appointments etc.) via phone at (505) 787-2640.

Priscilla Roth-wall is licensed to practice in New Mexico (license number PSY1470) 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 1457386963.

Contact Information

	Priscilla Roth-wall, PHD
	3751 N Butler Ave Ste 115, Farmington, NM 87401-6425
	(505) 787-2640
	(505) 787-2789

Map and Direction

Healthcare Provider's Profile

Full Name	Priscilla Roth-wall
Gender	Female
Speciality	Psychologist - Clinical
Location	3751 N Butler Ave Ste 115, Farmington, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457386963
Provider Enumeration Date: 07/12/2006
Last Update Date: 04/30/2020

Medicare PECOS Information:

PECOS PAC ID: 5991699688
Enrollment ID: I20171027002092

Medical Identifiers

Medical identifiers for Priscilla Roth-wall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457386963	NPI	-	NPPES
PSY1470	Other	NM	PSYCHOLOGY LICENSE
16970748	Medicaid	NM
73763700	Other	NM	MAGELLAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	PSY1470 (New Mexico)	Secondary
103TM1800X	Psychologist - Intellectual & Developmental Disabilities	PSY1470 (New Mexico)	Secondary
103TC0700X	Psychologist - Clinical	PSY1470 (New Mexico)	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. Priscilla Roth-wall allows following entities to bill medicare on her behalf.

Entity Name	San Juan Regional Medical Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639662901 PECOS PAC ID: 4587559505 Enrollment ID: O20040218000865

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. Priscilla Roth-wall 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
Priscilla Roth-wall, PHD 3751 N Butler Ave Ste 115, Farmington, NM 87401-6425 Ph: (505) 787-2640	Priscilla Roth-wall, PHD 3751 N Butler Ave Ste 115, Farmington, NM 87401-6425 Ph: (505) 787-2640

Reviews and Comments

Psychologist in Farmington, NM

John Paulino, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1400a E 20th St, Farmington, NM 87401 Phone: 941-286-3461
Robert Edward Sherrill Jr., PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 701 W Apache St, Farmington, NM 87401 Phone: 505-327-7777 Fax: 505-327-7779
Marc Hanna Irwin, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 851 Andrea Dr, Suite 4, Building E, Farmington, NM 87401 Phone: 505-324-5855
Alejandrina Garcia, SCHOOL PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1400a E 20th St, Farmington, NM 87401 Phone: 505-599-8617 Fax: 505-599-8810
Ms. Rebecca G Jasper, MSW ACSW LISW Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2901 E 20th St, Suite 104, Farmington, NM 87402 Phone: 505-326-0241 Fax: 505-325-8356
Dr. Talya Steinberg, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 4109 Old Mission Rd, Farmington, NM 87401 Phone: 508-439-1421

Priscilla Roth-wall, PHD - Medicare Psychologist in Farmington, NM