Dmitriy Kazakov, is a medicare enrolled "Clinical Neuropsychologist" provider in Cheshire, Connecticut. He graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Northeast Neuropsychology Llc and his current practice location is
609 W Johnson Ave Ste 104, Cheshire, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 272-6007.
Dmitriy Kazakov is licensed to practice in Connecticut (license number 4127) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336804541.
Healthcare Provider's Profile
| Full Name | Dmitriy Kazakov |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 5 Years |
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| Location | 609 W Johnson Ave Ste 104, Cheshire, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dmitriy Kazakov graduated from medical school in 2019
NPI Data:
- NPI Number: 1336804541
- Provider Enumeration Date: 11/02/2021
- Last Update Date: 11/02/2021
Medicare PECOS Information:
- PECOS PAC ID: 1759774185
- Enrollment ID: I20220208001835
Medical Identifiers
Medical identifiers for Dmitriy Kazakov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336804541 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 4127 (Connecticut) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 4127 (Connecticut) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Northeast Neuropsychology Llc | 3375602931 | 9 |
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. Dmitriy Kazakov allows following entities to bill medicare on his behalf.
| Entity Name | Northeast Neuropsychology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396991956
PECOS PAC ID: 3375602931
Enrollment ID: O20081111000670 |
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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. Dmitriy Kazakov 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 |
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Dmitriy Kazakov,
609 W Johnson Ave Ste 104,
Cheshire, CT 06410-4506
Ph: (203) 272-6007 | Dmitriy Kazakov,
609 W Johnson Ave Ste 104,
Cheshire, CT 06410-4506
Ph: (203) 272-6007 |
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