Walter O Bockting, PHD in Minneapolis, MN - Medicare Psychologist Provider

Walter O Bockting, PHD is a medicare enrolled "Psychologist - Clinical" provider in Minneapolis, Minnesota. His current practice location is 1300 S 2nd St, Suite 180, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 625-1500.

Walter O Bockting is licensed to practice in New York (license number 020658) 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 1104901172.

Contact Information

	Walter O Bockting, PHD
	1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075
	(612) 625-1500
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Walter O Bockting
Gender	Male
Speciality	Psychologist - Clinical
Location	1300 S 2nd St, Minneapolis, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104901172
Provider Enumeration Date: 10/26/2006
Last Update Date: 03/19/2024

Medicare PECOS Information:

PECOS PAC ID: 9537284591
Enrollment ID: I20150805009333

Medical Identifiers

Medical identifiers for Walter O Bockting such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104901172	NPI	-	NPPES
048313300	Medicaid	MN
1007664	Other	MN	PREFERREDONE
602T9BO	Other	MN	BLUE CROSS BLUE SHIELD
61-81256	Other	MN	MEDICA - CHOICE
102450	Other	MN	UCARE
HP50070	Other	MN	HEALTHPARTNERS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	LP2505 (Minnesota)	Secondary
103TC0700X	Psychologist - Clinical	LP2505 (Minnesota)	Secondary
103TC0700X	Psychologist - Clinical	020658 (New York)	Primary

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. Walter O Bockting 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
Walter O Bockting, PHD 3989 Central Ave Ne, Suite 300, Columbia Heights, MN 55421-3900 Ph: (612) 625-1500	Walter O Bockting, PHD 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 Ph: (612) 625-1500

Reviews and Comments

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Walter O Bockting, PHD - Medicare Psychologist in Minneapolis, MN