Michelle Kluczinske, RN in Fremont, CA - Medicare Nurse Practitioner

Michelle Kluczinske, RN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fremont, California. Her current practice location is 39180 Liberty St Ste 205, Fremont, California. You can reach out to her office (for appointments etc.) via phone at (510) 617-5699.

Michelle Kluczinske is licensed to practice in California (license number 95021862) 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 1114560182.

Contact Information

	Michelle Kluczinske, RN
	39180 Liberty St Ste 205, Fremont, CA 94538-2586
	(510) 617-5699
	Not Available

Map and Direction

Provider's Profile

Full Name	Michelle Kluczinske
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	39180 Liberty St Ste 205, Fremont, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114560182
Provider Enumeration Date: 10/23/2019
Last Update Date: 05/17/2023

Medicare PECOS Information:

PECOS PAC ID: 2365811148
Enrollment ID: I20221219000618

Medical Identifiers

Medical identifiers for Michelle Kluczinske such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114560182	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	712240 (New York)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	404183 (New York)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95021862 (California)	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. Michelle Kluczinske allows following entities to bill medicare on her behalf.

Entity Name	Memory Check Psychological Services, A Professional Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912184219 PECOS PAC ID: 7416856422 Enrollment ID: O20040107001021

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. Michelle Kluczinske 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
Michelle Kluczinske, RN 39180 Liberty St Ste 205, Fremont, CA 94538-2586 Ph: (510) 617-5699	Michelle Kluczinske, RN 39180 Liberty St Ste 205, Fremont, CA 94538-2586 Ph: (510) 617-5699

Reviews and Comments

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Michelle Kluczinske, RN - Medicare Nurse Practitioner in Fremont, CA