Dr Derron Kg Ambrose, PHD in St Thomas, VI - Medicare Psychologist Provider

Dr Derron Kg Ambrose, PHD is a medicare enrolled "Psychologist" provider in St Thomas, Virgin Island. His current practice location is 6115 Estate Smith Bay Unit 5, St Thomas, Virgin Island. You can reach out to his office (for appointments etc.) via phone at (340) 714-2348.

Dr Derron Kg Ambrose is licensed to practice in Washington (license number PY60949800) 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 1164861233.

Contact Information

	Dr Derron Kg Ambrose, PHD
	6115 Estate Smith Bay Unit 5, St Thomas, VI 00802-1330
	(340) 714-2348
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Derron Kg Ambrose
Gender	Male
Speciality	Psychologist
Location	6115 Estate Smith Bay Unit 5, St Thomas, Virgin Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164861233
Provider Enumeration Date: 06/21/2013
Last Update Date: 09/21/2022

Medicare PECOS Information:

PECOS PAC ID: 4183009673
Enrollment ID: I20220920001622

Medical Identifiers

Medical identifiers for Dr Derron Kg Ambrose such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164861233	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PY60949800 (Washington)	Secondary
103TC0700X	Psychologist - Clinical	22-047-PSY (Virgin Island)	Secondary
103T00000X	Psychologist	PY60949800 (Washington)	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. Dr Derron Kg Ambrose allows following entities to bill medicare on his behalf.

Entity Name	Vi Government Hospital And Health Facilities Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487699047 PECOS PAC ID: 6204722879 Enrollment ID: O20040223000586

Entity Name	Synergy Fitness And Wellness Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013346832 PECOS PAC ID: 2365663267 Enrollment ID: O20141017000953

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 Derron Kg Ambrose 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 Derron Kg Ambrose, PHD Po Box 5, St Thomas, VI 00804-0005 Ph: (340) 714-2348	Dr Derron Kg Ambrose, PHD 6115 Estate Smith Bay Unit 5, St Thomas, VI 00802-1330 Ph: (340) 714-2348

Reviews and Comments

Psychologist in St Thomas, VI

Kirstyn Livingston, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9151 Estate Thomas, Suite 204, St Thomas, VI 00802 Phone: 340-774-2228 Fax: 240-714-2258
Desi Jeanette Xavier, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9150 Estate Thomas Ste 108, St Thomas, VI 00802 Phone: 340-473-5146
Ms. Susan M Julius, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7820 Estate Tutu Vly, St Thomas, VI 00802 Phone: 340-998-4355
Dr. Angelina Jovan Prince, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9151 Estate Thomas Ste 204, St Thomas, VI 00802 Phone: 340-774-2228
Dr. Sheena Myong Walker, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 9149 Estate Thomas, Suite 209a, St Thomas, VI 00802 Phone: 340-774-2228
Dr. Ramona Moss, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 31 Sapphire Bay West D, St Thomas, VI 00802 Phone: 340-775-1103 Fax: 340-775-1103

Dr Derron Kg Ambrose, PHD - Medicare Psychologist in St Thomas, VI