Clay Justin Crockett, PMHNP-BC - Medicare Nurse Practitioner in Gilbert, AZ

Clay Justin Crockett, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Gilbert, Arizona. His current practice location is 1525 S Higley Rd Ste 104, Gilbert, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 401-2110.

Clay Justin Crockett is licensed to practice in Arizona (license number 294847) 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 1164120150.

Contact Information

Clay Justin Crockett, PMHNP-BC
1525 S Higley Rd Ste 104,
Gilbert, AZ 85296-5045
(480) 401-2110
(507) 519-5792

Map and Direction




Provider's Profile

Full NameClay Justin Crockett
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1525 S Higley Rd Ste 104, Gilbert, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1164120150
  • Provider Enumeration Date: 02/20/2023
  • Last Update Date: 06/25/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8527420116
  • Enrollment ID: I20230814003231

Medical Identifiers

Medical identifiers for Clay Justin Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164120150NPI-NPPES
138626MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0808XRegistered Nurse - Psychiatric/mental Health RN197246 (Arizona)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 294847 (Arizona)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. Clay Justin Crockett allows following entities to bill medicare on his behalf.
Entity NameCrisis Preparation And Recovery Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588720650
PECOS PAC ID: 3173624384
Enrollment ID: O20070718000308
Entity NameNeighborhood Outreach Access To Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942518550
PECOS PAC ID: 3577743764
Enrollment ID: O20110204000504
Entity NameDr Gregory Carr Md Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386041861
PECOS PAC ID: 3072828607
Enrollment ID: O20150812006188

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. Clay Justin Crockett 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
Clay Justin Crockett, PMHNP-BC
1525 S Higley Rd Ste 104,
Gilbert, AZ 85296-5045

Ph: (480) 401-2110
Clay Justin Crockett, PMHNP-BC
1525 S Higley Rd Ste 104,
Gilbert, AZ 85296-5045

Ph: (480) 401-2110

Reviews and Comments


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Phone: 480-890-7705    Fax: 480-398-8095

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.