Shiraz P Tata, PHD in Rockford, IL - Medicare Clinical Psychologist Provider

Shiraz P Tata, PHD is a medicare enrolled "Psychologist" provider in Rockford, Illinois. She went to Southern Illinois University School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is 6072 Brynwood Dr Ste 107, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 519-2949.

Shiraz P Tata is licensed to practice in Illinois (license number 071-004963) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336298504.

Contact Information

	Shiraz P Tata, PHD
	6072 Brynwood Dr Ste 107, Rockford, IL 61114
	(815) 519-2949
	(815) 637-4483

Map and Direction

Healthcare Provider's Profile

Full Name	Shiraz P Tata
Gender	Female
Speciality	Clinical Psychologist
Experience	31 Years
Location	6072 Brynwood Dr Ste 107, Rockford, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shiraz P Tata attended and graduated from Southern Illinois University School Of Medicine in 1993

NPI Data:

NPI Number: 1336298504
Provider Enumeration Date: 01/09/2007
Last Update Date: 06/18/2018

Medicare PECOS Information:

PECOS PAC ID: 4385980812
Enrollment ID: I20190103003268

Medical Identifiers

Medical identifiers for Shiraz P Tata such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336298504	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	071-004963 (Illinois)	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. Shiraz P Tata allows following entities to bill medicare on her behalf.

Entity Name	Shiraz Tata Phd Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083109524 PECOS PAC ID: 2668718198 Enrollment ID: O20190103003194

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. Shiraz P Tata 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
Shiraz P Tata, PHD 6072 Brynwood Dr Ste 107, Rockford, IL 61114-5829 Ph: (815) 519-2949	Shiraz P Tata, PHD 6072 Brynwood Dr Ste 107, Rockford, IL 61114 Ph: (815) 519-2949

Reviews and Comments

Psychologist in Rockford, IL

Dr. Frank Eugene Cushing, ED.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2823 Glenwood Ave, Rockford, IL 61101 Phone: 815-968-5342 Fax: 815-968-4656
James M Viggiano, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 6975 Redansa Dr, Rockford, IL 61108 Phone: 815-398-7000 Fax: 815-398-0671
Dr. Jennifer Mary Wilson, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5702 Elaine Dr, Suite A, Rockford, IL 61108 Phone: 815-601-3981 Fax: 815-399-1959
Dr. George Joseph Didier, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 6066 Strathmoor Dr, C3, Rockford, IL 61107 Phone: 815-399-2611 Fax: 815-885-2611
Dr. Thomas Boone Dudgeon, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6066 Strathmoor Dr, 3c, Rockford, IL 61107 Phone: 815-399-9303 Fax: 815-399-9306
Dr. Sheila M Stone, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5301 E State St, Ste. 203, Rockford, IL 61108 Phone: 866-874-5381
Judith Trigg, PSY.D Psychologist Medicare: Medicare Enrolled Practice Location: 6072 Brynwood Dr, Ste 105, Rockford, IL 61114 Phone: 815-398-7000 Fax: 815-395-0671

Shiraz P Tata, PHD - Medicare Psychologist in Rockford, IL