Dr Bruce Holder, PHD is a medicare enrolled "Counselor - Mental Health" provider in Upland, Indiana. His current practice location is
525 S Main St, Upland, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 298-9315.
Dr Bruce Holder is licensed to practice in Indiana (license number 39000465A) 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 1639701279.
Healthcare Provider's Profile
Full Name | Dr Bruce Holder |
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Gender | Male |
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Speciality | Counselor - Mental Health |
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Location | 525 S Main St, Upland, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1639701279
- Provider Enumeration Date: 02/11/2020
- Last Update Date: 02/11/2020
Medicare PECOS Information:
- PECOS PAC ID: 8820433402
- Enrollment ID: I20240305003614
Medical Identifiers
Medical identifiers for Dr Bruce Holder such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639701279 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 39000465A (Indiana) | 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. Dr Bruce Holder allows following entities to bill medicare on his behalf.
Entity Name | Extended Care Specialists, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20050318000726 |
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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. Dr Bruce Holder 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 |
Dr Bruce Holder, PHD 525 S Main St, Upland, IN 46989-9101 Ph: (765) 997-1945 | Dr Bruce Holder, PHD 525 S Main St, Upland, IN 46989-9101 Ph: (765) 298-9315 |
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