Russell Dean Park, PHD in Jamestown, CA - Medicare Psychologist Provider

Russell Dean Park, PHD is a medicare enrolled "Psychologist - Clinical" provider in Jamestown, California. His current practice location is 5100 O'byrnes Ferry Rd., Jamestown, California. You can reach out to his office (for appointments etc.) via phone at (209) 984-5291.

Russell Dean Park is licensed to practice in California (license number PSY14275) 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 1326020710.

Contact Information

	Russell Dean Park, PHD
	5100 O'byrnes Ferry Rd., Jamestown, CA 95327
	(209) 984-5291
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Russell Dean Park
Gender	Male
Speciality	Psychologist - Clinical
Location	5100 O'byrnes Ferry Rd., Jamestown, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1326020710
Provider Enumeration Date: 11/19/2005
Last Update Date: 04/04/2013

Medicare PECOS Information:

PECOS PAC ID: 3577598929
Enrollment ID: I20051004000906

Medical Identifiers

Medical identifiers for Russell Dean Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326020710	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY14275 (California)	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. Russell Dean Park allows following entities to bill medicare on his behalf.

Entity Name	Memory Check Psychological Services, A Professional Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912184219 PECOS PAC ID: 7416856422 Enrollment ID: O20040107001021

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. Russell Dean Park 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
Russell Dean Park, PHD Po Box 215, Monte Rio, CA 95462-0215 Ph: (209) 380-3932	Russell Dean Park, PHD 5100 O'byrnes Ferry Rd., Jamestown, CA 95327 Ph: (209) 984-5291

Reviews and Comments

Psychologist in Jamestown, CA

Dr. Minou Alexander, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5100 O'byrner Ferry Rd., Sierra Conservation Center, Jamestown, CA 95327 Phone: 209-984-5291 Fax: 209-984-8587
Mr. Richard Perry Halliburton, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5100 Obyrnes Ferry Rd, Jamestown, CA 95327 Phone: 209-984-5291
Dr. Katherine Jean Robertson, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5100 Obyrnes Ferry Rd, Jamestown, CA 95327 Phone: 209-984-5291
Dr. Michael A Backlund, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5100 O Brynes Ferry Rd, Jamestown, CA 95327 Phone: 209-984-5291

Russell Dean Park, PHD - Medicare Psychologist in Jamestown, CA