Dr Michael Fanning, is a medicare enrolled "Psychologist - Clinical" provider in Palestine, Texas. His current practice location is
210 W Oak St, Palestine, Texas. You can reach out to his office (for appointments etc.) via phone at
(404) 734-6757.
Dr Michael Fanning is licensed to practice in Texas (license number 38300) 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 1790184638.
Healthcare Provider's Profile
| Full Name | Dr Michael Fanning |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 210 W Oak St, Palestine, Texas |
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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: 1790184638
- Provider Enumeration Date: 08/15/2014
- Last Update Date: 03/27/2020
Medicare PECOS Information:
- PECOS PAC ID: 7810317260
- Enrollment ID: I20201023000995
Medical Identifiers
Medical identifiers for Dr Michael Fanning such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790184638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 38300 (Texas) | Primary |
| 172A00000X | Driver | (* (Not Available)) | 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 Michael Fanning allows following entities to bill medicare on his behalf.
| Entity Name | Alaniz Counseling And Behavioral Center Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811288731
PECOS PAC ID: 0648596924
Enrollment ID: O20150304000138 |
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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 Michael Fanning 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 Michael Fanning,
9725 Decatur Dr,
Indianapolis, IN 46256-9656
Ph: (312) 656-5489 | Dr Michael Fanning,
210 W Oak St,
Palestine, TX 75801-2710
Ph: (404) 734-6757 |
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