Damien Tilliman, in Long Island City, NY - Medicare Psychologist Provider

Damien Tilliman, is a medicare enrolled "Psychologist - Clinical" provider in Long Island City, New York. His current practice location is 4332 22nd St Ste 203, Long Island City, New York. You can reach out to his office (for appointments etc.) via phone at (585) 750-0091.

Damien Tilliman is licensed to practice in New York (license number 022266) 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 1588205272.

Contact Information

	Damien Tilliman,
	4332 22nd St Ste 203, Long Island City, NY 11101-5077
	(585) 750-0091
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Damien Tilliman
Gender	Male
Speciality	Psychologist - Clinical
Location	4332 22nd St Ste 203, Long Island City, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588205272
Provider Enumeration Date: 10/03/2019
Last Update Date: 10/03/2019

Medicare PECOS Information:

PECOS PAC ID: 3678907326
Enrollment ID: I20210324002750

Medical Identifiers

Medical identifiers for Damien Tilliman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588205272	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	022266 (New York)	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. Damien Tilliman allows following entities to bill medicare on his behalf.

Entity Name	Mind In Motion Psychological Services, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093362816 PECOS PAC ID: 0941634695 Enrollment ID: O20200106000994

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. Damien Tilliman 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
Damien Tilliman, 4332 22nd St Ste 203, Long Island City, NY 11101-5077 Ph: (585) 750-0091	Damien Tilliman, 4332 22nd St Ste 203, Long Island City, NY 11101-5077 Ph: (585) 750-0091

Reviews and Comments

Psychologist in Long Island City, NY

Dr. Jihee Cho, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 4332 22nd St, Ste 203, Long Island City, NY 11101 Phone: 917-243-1667
Konata Stallings, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4140 27th St, Long Island City, NY 11101 Phone: 718-784-2240
Jaclyn Shlisky, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4545 Center Blvd Apt 518, Long Island City, NY 11109 Phone: 516-330-6628
Amanda Diana Persaud, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4628 Vernon Blvd Ste 103, Long Island City, NY 11101 Phone: 914-494-2936
Dr. Jennifer Lauren Heslin, PSY.D Psychologist Medicare: Medicare Enrolled Practice Location: 4140 27th St, Long Island City, NY 11101 Phone: 718-784-2240 Fax: 718-784-0161
Aviva Glass, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5-31 50th Avenue, Long Island City, NY 11101 Phone: 917-647-9042
Pasquale Depetris, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4136 27th St, Long Island City, NY 11101 Phone: 718-389-5100

Damien Tilliman, - Medicare Psychologist in Long Island City, NY