Dr Michelle Koren Boswell, PHD, HSPP is a medicare enrolled "Psychologist - Clinical" provider in San Diego, California. Her current practice location is
4715 Viewridge Ave Ste 230, San Diego, California. You can reach out to her office (for appointments etc.) via phone at
(800) 257-8715.
Dr Michelle Koren Boswell is licensed to practice in Indiana (license number 20042452A) 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 1649404948.
Healthcare Provider's Profile
| Full Name | Dr Michelle Koren Boswell |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 4715 Viewridge Ave Ste 230, San Diego, California |
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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: 1649404948
- Provider Enumeration Date: 05/14/2009
- Last Update Date: 11/10/2015
Medicare PECOS Information:
- PECOS PAC ID: 2163569047
- Enrollment ID: I20091026000488
Medical Identifiers
Medical identifiers for Dr Michelle Koren Boswell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1649404948 | NPI | - | NPPES |
| 201003430 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 20042452A (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 Michelle Koren Boswell allows following entities to bill medicare on her behalf.
| Entity Name | Valley Oaks Health Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689629990
PECOS PAC ID: 7315927563
Enrollment ID: O20040720001286 |
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| Entity Name | Aims Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376072785
PECOS PAC ID: 6406126572
Enrollment ID: O20170721002478 |
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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 Michelle Koren Boswell 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 |
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Dr Michelle Koren Boswell, PHD, HSPP
10705 Hendricks Pl,
Crown Point, IN 46307-2926
Ph: (219) 688-4523 | Dr Michelle Koren Boswell, PHD, HSPP
4715 Viewridge Ave Ste 230,
San Diego, CA 92123-1680
Ph: (800) 257-8715 |
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