Dr Mirna E Ballestas, PSYD - Medicare Counselor in Chicago, IL

Dr Mirna E Ballestas, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Chicago, Illinois. Her current practice location is 4633 N Western Ave Ste 205, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (312) 476-9588.

Dr Mirna E Ballestas is licensed to practice in Illinois (license number 071.007650) 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 1942427521.

Contact Information

Dr Mirna E Ballestas, PSYD
4633 N Western Ave Ste 205,
Chicago, IL 60625-2087
(312) 476-9588
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameDr Mirna E Ballestas
GenderFemale
SpecialityPsychologist - Clinical
Location4633 N Western Ave Ste 205, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1942427521
  • Provider Enumeration Date: 04/18/2007
  • Last Update Date: 08/25/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 3678628328
  • Enrollment ID: I20090901000306

Medical Identifiers

Medical identifiers for Dr Mirna E Ballestas such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942427521NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health 180-005584 (Illinois)Secondary
103TC0700XPsychologist - Clinical 071.007650 (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. Dr Mirna E Ballestas allows following entities to bill medicare on her behalf.
Entity NameCounseling And Diagnostic Center Of Woodfield, Ltd.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821151135
PECOS PAC ID: 8729094800
Enrollment ID: O20060227000502

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 Mirna E Ballestas 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 AddressPractice Location Address
Dr Mirna E Ballestas, PSYD
5548 N Virginia Ave,
Chicago, IL 60625-3918

Ph: (773) 610-8039
Dr Mirna E Ballestas, PSYD
4633 N Western Ave Ste 205,
Chicago, IL 60625-2087

Ph: (312) 476-9588

Reviews and Comments


Psychologist in Chicago, IL


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.