Gregory Pouliot, PHD in South Bend, IN - Medicare Clinical Psychologist Provider

Gregory Pouliot, PHD is a medicare enrolled "Psychologist - Clinical" provider in South Bend, Indiana. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Beacon Medical Group Inc and his current practice location is 714 N Michigan St, South Bend, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 647-7477.

Gregory Pouliot is licensed to practice in Indiana (license number 20042945A) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336549328.

Contact Information

	Gregory Pouliot, PHD
	714 N Michigan St, South Bend, IN 46601-1035
	(574) 647-7477
	(574) 647-3655

Map and Direction

Healthcare Provider's Profile

Full Name	Gregory Pouliot
Gender	Male
Speciality	Clinical Psychologist
Experience	10 Years
Location	714 N Michigan St, South Bend, Indiana
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Gregory Pouliot graduated from medical school in 2014

NPI Data:

NPI Number: 1336549328
Provider Enumeration Date: 08/27/2014
Last Update Date: 03/31/2021

Medicare PECOS Information:

PECOS PAC ID: 5890083646
Enrollment ID: I20161011000133

Medical Identifiers

Medical identifiers for Gregory Pouliot such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336549328	NPI	-	NPPES
201392530	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	20042945A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Hospital Of South Bend	South bend, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Beacon Medical Group Inc	1254243306	452

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. Gregory Pouliot allows following entities to bill medicare on his behalf.

Entity Name	Beacon Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657

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. Gregory Pouliot 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
Gregory Pouliot, PHD 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610	Gregory Pouliot, PHD 714 N Michigan St, South Bend, IN 46601-1035 Ph: (574) 647-7477

Reviews and Comments

Psychologist in South Bend, IN

Rachel Njuguna, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131
Barbara S Searle, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3603 E Jefferson Blvd, Suiteb, South Bend, IN 46615 Phone: 574-237-1003 Fax: 574-237-1006
Dr. George Gilbert Moss, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 22057 Sandybrook Dr, South Bend, IN 46628 Phone: 574-514-4302
Nicole Gebadlo, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2505 E Jefferson Blvd, South Bend, IN 46615 Phone: 574-289-4831 Fax: 574-234-2075
Vaughn Thomas Mawhinney, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 828 E Colfax Ave, South Bend, IN 46617 Phone: 574-251-1531 Fax: 574-234-5710
Joann Michelle Jackson, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652
Jack Garden, HSPP Psychologist Medicare: Medicare Enrolled Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131

Gregory Pouliot, PHD - Medicare Psychologist in South Bend, IN