Dr Jessica Maryniuk, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Eagan, Minnesota. Her current practice location is
3450 Oleary Ln, Eagan, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(651) 365-8213.
Dr Jessica Maryniuk is licensed to practice in Minnesota (license number LP6373) 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 1396140422.
Healthcare Provider's Profile
| Full Name | Dr Jessica Maryniuk |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 3450 Oleary Ln, Eagan, Minnesota |
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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: 1396140422
- Provider Enumeration Date: 10/31/2014
- Last Update Date: 03/05/2019
Medicare PECOS Information:
- PECOS PAC ID: 1850632324
- Enrollment ID: I20190410000992
Medical Identifiers
Medical identifiers for Dr Jessica Maryniuk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396140422 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | LP6373 (Minnesota) | 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 Jessica Maryniuk allows following entities to bill medicare on her behalf.
| Entity Name | Eagan Counseling Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1144311184
PECOS PAC ID: 2860304045
Enrollment ID: O20031105000326 |
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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 Jessica Maryniuk 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 Jessica Maryniuk, PSYD
3450 Oleary Ln,
Eagan, MN 55123-2340
Ph: (574) 722-5151 | Dr Jessica Maryniuk, PSYD
3450 Oleary Ln,
Eagan, MN 55123-2340
Ph: (651) 365-8213 |
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