Stacy Kathryn Mutrynowski, LMFT in San Leandro, CA - Medicare Marriage & Family Therapist Provider

Stacy Kathryn Mutrynowski, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in San Leandro, California. Her current practice location is 2401 Merced St, San Leandro, California. You can reach out to her office (for appointments etc.) via phone at (510) 362-3553.

Stacy Kathryn Mutrynowski is licensed to practice in California (license number 130363) 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 1831614866.

Contact Information

	Stacy Kathryn Mutrynowski, LMFT
	2401 Merced St, San Leandro, CA 94577-4228
	(510) 362-3553
	(510) 618-5830

Map and Direction

Healthcare Provider's Profile

Full Name	Stacy Kathryn Mutrynowski
Gender	Female
Speciality	Marriage & Family Therapist
Location	2401 Merced St, San Leandro, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831614866
Provider Enumeration Date: 08/10/2017
Last Update Date: 10/31/2022

Medicare PECOS Information:

PECOS PAC ID: 5698118982
Enrollment ID: I20240202002478

Medical Identifiers

Medical identifiers for Stacy Kathryn Mutrynowski such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831614866	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	130363 (California)	Primary
106H00000X	Marriage & Family Therapist	108812 (California)	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. Stacy Kathryn Mutrynowski allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Stacy Kathryn Mutrynowski 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
Stacy Kathryn Mutrynowski, LMFT 1025 Adason Dr, San Leandro, CA 94578-3613 Ph: (818) 613-3394	Stacy Kathryn Mutrynowski, LMFT 2401 Merced St, San Leandro, CA 94577-4228 Ph: (510) 362-3553

Reviews and Comments

Marriage & Family Therapist in San Leandro, CA

Ms. Emilee Ann Dunlop, AMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 15430 Foothill Blvd, San Leandro, CA 94578 Phone: 510-357-3562
Jing Zhao, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2275 Arlington Dr, San Leandro, CA 94578 Phone: 510-317-1444
Cindy Hill-ford, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 545 Estudillo Ave, San Leandro, CA 94577 Phone: 510-352-9200 Fax: 510-875-1044
Cristina Rosas, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1000 San Leandro Blvd, Suite 300, San Leandro, CA 94577 Phone: 510-418-4421
Ms. Alison Clare Mckenzie, M.A., MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1000 San Leandro Blvd., Suite 300, San Leandro, CA 94577 Phone: 510-667-3176
Adriana Najera, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 13847 E 14th St Ste 215, San Leandro, CA 94578 Phone: 510-430-1115
Kevin Calaway, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2275 Arlington Dr, San Leandro, CA 94578 Phone: 510-481-1222

Stacy Kathryn Mutrynowski, LMFT - Medicare Couples Therapy in San Leandro, CA