Carly Jean Gutierrez, in Highland, NY - Medicare Counselor Provider

Carly Jean Gutierrez, is a medicare enrolled "Counselor" provider in Highland, New York. Her current practice location is 106 Vineyard Ave, Highland, New York. You can reach out to her office (for appointments etc.) via phone at (845) 691-9191.

Carly Jean Gutierrez is licensed to practice in New York (license number 010069) 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 1114415015.

Contact Information

	Carly Jean Gutierrez,
	106 Vineyard Ave, Highland, NY 12528-1422
	(845) 691-9191
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Carly Jean Gutierrez
Gender	Female
Speciality	Counselor
Location	106 Vineyard Ave, Highland, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114415015
Provider Enumeration Date: 04/25/2018
Last Update Date: 04/21/2021

Medicare PECOS Information:

PECOS PAC ID: 7810348042
Enrollment ID: I20240111002818

Medical Identifiers

Medical identifiers for Carly Jean Gutierrez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114415015	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	010069 (New York)	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. Carly Jean Gutierrez allows following entities to bill medicare on her behalf.

Entity Name	Park Slope Center For Mental Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851382188 PECOS PAC ID: 8224936455 Enrollment ID: O20031226000202

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. Carly Jean Gutierrez 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
Carly Jean Gutierrez, 106 Vineyard Ave, Highland, NY 12528-1422 Ph: (845) 691-9191	Carly Jean Gutierrez, 106 Vineyard Ave, Highland, NY 12528-1422 Ph: (845) 691-9191

Reviews and Comments

Counselor in Highland, NY

Lawrence John Quintiliani, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9 Lisa Dr., Highland, NY 12528 Phone: 845-691-6502 Fax: 845-691-6502
Teresa Hawkins, CASAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 Vineyard Ave, Highland, NY 12528 Phone: 845-691-9191
Lauren Widmark, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 106 Vineyard Ave, Highland, NY 12528 Phone: 845-691-9191
Nora Gagnon, CASAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 Vineyard Ave, Highland, NY 12528 Phone: 845-691-9191
Ms. Barbara Brown, CASAC-T Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 Vineyard Avenue, Highland, NY 12428 Phone: 845-691-9191 Fax: 845-691-9339
Mr. Michael A Miano, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 247 Sterling Pl, Highland, NY 12528 Phone: 845-287-0755

Carly Jean Gutierrez, - Medicare Counselor in Highland, NY