Dr Tina Kaur Dhaliwal, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Mequon, Wisconsin. Her current practice location is
9653 N Granville Rd, Mequon, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 404-7166.
Dr Tina Kaur Dhaliwal is licensed to practice in Wisconsin (license number 3033-57) 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 1760703912.
Healthcare Provider's Profile
| Full Name | Dr Tina Kaur Dhaliwal |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 9653 N Granville Rd, Mequon, Wisconsin |
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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: 1760703912
- Provider Enumeration Date: 06/22/2010
- Last Update Date: 05/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 7012154024
- Enrollment ID: I20130511000073
Medical Identifiers
Medical identifiers for Dr Tina Kaur Dhaliwal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1760703912 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 3033-57 (Wisconsin) | 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 Tina Kaur Dhaliwal allows following entities to bill medicare on her behalf.
| Entity Name | Columbia St Marys Hospital Milwaukee Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
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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 Tina Kaur Dhaliwal 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 Tina Kaur Dhaliwal, PSYD 9653 N Granville Rd, Mequon, WI 53097-3513 Ph: (262) 404-7166 | Dr Tina Kaur Dhaliwal, PSYD 9653 N Granville Rd, Mequon, WI 53097-3513 Ph: (262) 404-7166 |
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