Dr Casey Lee Mcdougall, PHD, LP is a medicare enrolled "Psychologist - Clinical" provider in Red Lake, Minnesota. His current practice location is
Hwy 1 Hospital Drive, Box 497, Red Lake, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 679-3912.
Dr Casey Lee Mcdougall is licensed to practice in Minnesota (license number LP 5341) 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 1548563620.
Healthcare Provider's Profile
| Full Name | Dr Casey Lee Mcdougall |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | Hwy 1 Hospital Drive, Red Lake, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1548563620
- Provider Enumeration Date: 12/13/2010
- Last Update Date: 07/11/2012
Medicare PECOS Information:
- PECOS PAC ID: 7315126307
- Enrollment ID: I20200401000376
Medical Identifiers
Medical identifiers for Dr Casey Lee Mcdougall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548563620 | NPI | - | NPPES |
| 1508809765 | Medicaid | MN | |
| LP 5341 | Other | MN | MN BOARD OF PSYCHOLOGY LICENSE # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | LP 5341 (Minnesota) | Primary |
| 103T00000X | Psychologist | LP 5341 (Minnesota) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | LP 5341 (Minnesota) | 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. Dr Casey Lee Mcdougall allows following entities to bill medicare on his behalf.
| Entity Name | Inetmed Rx2 Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487107363
PECOS PAC ID: 2062796709
Enrollment ID: O20170224002051 |
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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. Dr Casey Lee Mcdougall 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 |
|---|
Dr Casey Lee Mcdougall, PHD, LP
Box 497, Hwy 1 Ave,
Red Lake, MN 56671
Ph: (218) 679-3912 | Dr Casey Lee Mcdougall, PHD, LP
Hwy 1 Hospital Drive, Box 497,
Red Lake, MN 56671
Ph: (218) 679-3912 |
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