Dr Diane Logan, PHD, CSAC is a medicare enrolled "Psychologist - Clinical" provider in Kailua Kona, Hawaii. Her current practice location is
75-5751 Kuakini Hwy Ste 104, Kailua Kona, Hawaii. You can reach out to her office (for appointments etc.) via phone at
(808) 326-5629.
Dr Diane Logan is licensed to practice in Hawaii (license number PSY-1550) 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 1003207259.
Healthcare Provider's Profile
| Full Name | Dr Diane Logan |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 75-5751 Kuakini Hwy Ste 104, Kailua Kona, Hawaii |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003207259
- Provider Enumeration Date: 02/10/2015
- Last Update Date: 03/15/2020
Medicare PECOS Information:
- PECOS PAC ID: 3072820901
- Enrollment ID: I20150909003084
Medical Identifiers
Medical identifiers for Dr Diane Logan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003207259 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 2055-19 (Hawaii) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 2055-19I (Hawaii) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY-1550 (Hawaii) | 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 Diane Logan allows following entities to bill medicare on her behalf.
| Entity Name | Diane Logan Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1265068233
PECOS PAC ID: 5496185613
Enrollment ID: O20200430000794 |
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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 Diane Logan 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 Diane Logan, PHD, CSAC
Po Box 5488,
Kailua Kona, HI 96745-5488
Ph: (808) 785-5443 | Dr Diane Logan, PHD, CSAC
75-5751 Kuakini Hwy Ste 104,
Kailua Kona, HI 96740-1705
Ph: (808) 326-5629 |
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