Tyler Matthew Peckham, in Beavercreek, OH - Medicare Counselor Provider

Tyler Matthew Peckham, is a medicare enrolled "Counselor - Mental Health" provider in Beavercreek, Ohio. His current practice location is 3359 Kemp Rd Ste 200, Beavercreek, Ohio. You can reach out to his office (for appointments etc.) via phone at (937) 490-2090.

Tyler Matthew Peckham is licensed to practice in Ohio (license number E.2505064) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013423367.

Contact Information

	Tyler Matthew Peckham,
	3359 Kemp Rd Ste 200, Beavercreek, OH 45431-2567
	(937) 490-2090
	(937) 490-2780

Map and Direction

Healthcare Provider's Profile

Full Name	Tyler Matthew Peckham
Gender	Male
Speciality	Counselor - Mental Health
Location	3359 Kemp Rd Ste 200, Beavercreek, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013423367
Provider Enumeration Date: 12/22/2017
Last Update Date: 10/03/2025

Medicare PECOS Information:

PECOS PAC ID: 2365962529
Enrollment ID: I20250219001193

Medical Identifiers

Medical identifiers for Tyler Matthew Peckham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013423367	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	E.2505064 (Ohio)	Primary
171M00000X	Case Manager/care Coordinator	(* (Not Available))	Secondary

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. Tyler Matthew Peckham allows following entities to bill medicare on his behalf.

Entity Name	Samaritan Behavioral Health, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205888641 PECOS PAC ID: 0244148625 Enrollment ID: O20101007000860

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. Tyler Matthew Peckham 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
Tyler Matthew Peckham, 303 W Ross St, Troy, OH 45373-3931 Ph: (937) 216-9282	Tyler Matthew Peckham, 3359 Kemp Rd Ste 200, Beavercreek, OH 45431-2567 Ph: (937) 490-2090

Reviews and Comments

Counselor in Beavercreek, OH

David J Tieman, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1321 Research Park Dr, Beavercreek, OH 45432 Phone: 937-427-3837 Fax: 937-427-4516
Mrs. Deborah Kaye Baldwin, MS LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3351 Dayton Xenia Rd, Suite D, Beavercreek, OH 45432 Phone: 937-431-5035 Fax: 937-320-0824
Lynn Oliver, Counselor Medicare: Medicare Enrolled Practice Location: 1321 Research Park Dr, Beavercreek, OH 45432 Phone: 937-437-3837
Chester R Raleigh, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3183 Beaver Vu Dr Ste C, Beavercreek, OH 45434 Phone: 937-431-8014 Fax: 937-431-8042
John Hartman, Counselor Medicare: Medicare Enrolled Practice Location: 2145 N Fairfield Rd Ste 100, Beavercreek, OH 45431 Phone: 937-558-3900 Fax: 937-558-3999
Nicklas Wright, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3171 Beaver Vu Dr Ste C, Beavercreek, OH 45434 Phone: 937-306-8077

Tyler Matthew Peckham, - Medicare Counselor in Beavercreek, OH