Dr Marlyssa Rae Fillmore, PHD in Columbus, IN - Medicare Psychologist Provider

Dr Marlyssa Rae Fillmore, PHD is a medicare enrolled "Psychologist" provider in Columbus, Indiana. Her current practice location is 4980 Hunters Run, Columbus, Indiana. You can reach out to her office (for appointments etc.) via phone at (812) 552-1499.

Dr Marlyssa Rae Fillmore is licensed to practice in Indiana (license number 20043326A) 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 1831741461.

Contact Information

	Dr Marlyssa Rae Fillmore, PHD
	4980 Hunters Run, Columbus, IN 47201-8499
	(812) 552-1499
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Marlyssa Rae Fillmore
Gender	Female
Speciality	Psychologist
Location	4980 Hunters Run, Columbus, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831741461
Provider Enumeration Date: 07/13/2019
Last Update Date: 10/23/2024

Medicare PECOS Information:

PECOS PAC ID: 0840615951
Enrollment ID: I20200806002523

Medical Identifiers

Medical identifiers for Dr Marlyssa Rae Fillmore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831741461	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC1900X	Psychologist - Counseling	20043326A (Indiana)	Secondary
103TS0200X	Psychologist - School	10228724 (Indiana)	Secondary
103T00000X	Psychologist	20043326A (Indiana)	Primary
101YM0800X	Counselor - Mental Health	20043326A (Indiana)	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 Marlyssa Rae Fillmore allows following entities to bill medicare on her behalf.

Entity Name	Be Authentic Indy Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841901022 PECOS PAC ID: 7618341496 Enrollment ID: O20230317000399

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 Marlyssa Rae Fillmore 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 Marlyssa Rae Fillmore, PHD 4020 W Goeller Blvd, Ellie Mental Health, Columbus, IN 47201-8499 Ph: (812) 552-1499	Dr Marlyssa Rae Fillmore, PHD 4980 Hunters Run, Columbus, IN 47201-8499 Ph: (812) 552-1499

Reviews and Comments

Psychologist in Columbus, IN

Susan Shanklin, HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 806 Jackson St, Columbus, IN 47201 Phone: 812-377-5074 Fax: 812-378-8367
Dr. Theodore M Sharpe, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2530 Sandcrest Blvd, Columbus, IN 47203 Phone: 812-372-3177
Dr. Kelly H Lee, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3220 Middle Dr, Columbus, IN 47203 Phone: 812-378-4428 Fax: 812-378-4427
Darla Mckeeman, HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 806 Jackson St, Columbus, IN 47201 Phone: 812-377-5074 Fax: 812-378-8367
Lawrence Donald Ewert, HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 806 Jackson St, Columbus, IN 47201 Phone: 812-379-4033 Fax: 812-378-8367
Dr. Heather Rimstidt, PHD, NCSP, HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1200 Central Ave, Columbus, IN 47201 Phone: 812-376-4489
Natale Manes, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1200 Central Ave, Columbus, IN 47201 Phone: 812-390-1743

Dr Marlyssa Rae Fillmore, PHD - Medicare Psychologist in Columbus, IN