Dr Leslie Lange, PHD in Pelham, NY - Medicare Psychologist Provider

Dr Leslie Lange, PHD is a medicare enrolled "Psychologist - Clinical" provider in Pelham, New York. Her current practice location is 604 Monterey Ave, Pelham, New York. You can reach out to her office (for appointments etc.) via phone at (818) 657-9487.

Dr Leslie Lange is licensed to practice in New York (license number 022683) 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 1497207211.

Contact Information

	Dr Leslie Lange, PHD
	604 Monterey Ave, Pelham, NY 10803-2514
	(818) 657-9487
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Leslie Lange
Gender	Female
Speciality	Psychologist - Clinical
Location	604 Monterey Ave, Pelham, 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: 1497207211
Provider Enumeration Date: 10/27/2016
Last Update Date: 03/08/2025

Medicare PECOS Information:

PECOS PAC ID: 2860755618
Enrollment ID: I20180803001136

Medical Identifiers

Medical identifiers for Dr Leslie Lange such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497207211	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY12673 (California)	Secondary
103TC0700X	Psychologist - Clinical	022683 (New York)	Primary
103TC0700X	Psychologist - Clinical	003655 (Connecticut)	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 Leslie Lange allows following entities to bill medicare on her behalf.

Entity Name	Sentinel Services Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144891375 PECOS PAC ID: 6901290717 Enrollment ID: O20220221001691

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 Leslie Lange 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 Leslie Lange, PHD 604 Monterey Ave, Pelham, NY 10803-2514 Ph: (818) 657-9487	Dr Leslie Lange, PHD 604 Monterey Ave, Pelham, NY 10803-2514 Ph: (818) 657-9487

Reviews and Comments

Psychologist in Pelham, NY

Kelsi Ovca, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 151 Second Ave, Pelham, NY 10803 Phone: 929-276-2672
Dr. Lauren A Carner, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1000 Washington Ave, Prospect Hill School, Pelham, NY 10803 Phone: 914-738-6690
Sarah Bren, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 629 Fifth Ave Ste 109, Pelham, NY 10803 Phone: 845-535-1620
Mrs. Frieda S Dub, LCSW Psychologist Medicare: Not Enrolled in Medicare Practice Location: 629 Fifth Ave, In Care Of Medical Director Inc, Pelham, NY 10803 Phone: 914-629-6290 Fax: 914-633-7222
Dr. Sarah Desoye, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1000 Washington Ave, Pelham, NY 10803 Phone: 914-738-6690

Dr Leslie Lange, PHD - Medicare Psychologist in Pelham, NY