Dr Linda D Theis, LL P is a medicare enrolled "Psychologist - Clinical" provider in Fife Lake, Michigan. Her current practice location is
6035 Gonyer Rd Sw, Fife Lake, Michigan. You can reach out to her office (for appointments etc.) via phone at
(231) 715-9381.
Dr Linda D Theis is licensed to practice in Michigan (license number 6301015848) 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 1124447859.
Healthcare Provider's Profile
| Full Name | Dr Linda D Theis |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 6035 Gonyer Rd Sw, Fife Lake, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124447859
- Provider Enumeration Date: 04/09/2014
- Last Update Date: 04/09/2014
Medicare PECOS Information:
- PECOS PAC ID: 3072844356
- Enrollment ID: I20191017002366
Medical Identifiers
Medical identifiers for Dr Linda D Theis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1124447859 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 103TC0700X | Psychologist - Clinical | 6301015848 (Michigan) | 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 Linda D Theis allows following entities to bill medicare on her behalf.
| Entity Name | Old Town Psychological Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093989162 PECOS PAC ID: 2466600101 Enrollment ID: O20120921000057 |
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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 Linda D Theis 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 Linda D Theis, LL P 6035 Gonyer Rd Sw, Fife Lake, MI 49633-8214 Ph: (231) 715-9381 | Dr Linda D Theis, LL P 6035 Gonyer Rd Sw, Fife Lake, MI 49633-8214 Ph: (231) 715-9381 |
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